Would you offer EGFR inhibitors to a patient with metastatic lung adenocarcinoma EGFR L858R mutation and concomitant NRAS mutation both on blood based testing?  

This of course should be a rare event. Indeed, out of the hundreds of EGFR mutation positive patients I have seen, I have only encountered one case of concurrent KRAS G12C mutation and no concurrent NRAS mutation. The classic teaching is that KRAS mutations and EGFR mutations are mutually exclusive,...