What is the optimal initial therapy and management of Erdheim-Chester disease without actionable mutations such as BRAF or MAPK-ERK pathway alterations?  

Would refer to the latest ECD consensus guidelines and NCCN guidelines on histiocytic neoplasms for the answer to that question: Goyal et al., PMID 32187362 In short, here are the considerations:1. Even patients without bonafide MAPK-ERK pathway mutations can respond to a MEK-inhibitor suc...