What is your approach to a patient with an EGFR exon 19 mutated NSCLC who develops progression on osimertinib and repeat biopsy demonstrates the EGFR exon 19 mutation and a new BRAF V600E mutation?  

I have a couple of these patients - and the triplet combo seems to be helping them. There is really no good data to support this combination. However, the AE profile of these agents are different and combination should not increase toxicity theoretically. BRAF, MET, and EGFR are all on chromosome 7 ...