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Dual driver in non-small cell lung carcinoma – therapeutic dilemma

The presence of a targetable driver mutation in advanced non-small cell carcinoma is seen in about 40–50% of patients. The most common targetable driver identified is the mutation of the epidermal growth factor receptor gene. Conventionally, it was thought that these driver mutations of mutually exclusive. But due to the availability of a wider panel of molecular testing and highly sensitive methods of testing, there have been multiple case reports of more than one driver being identified in a single patient. Here in this series, we have described five such cases and have discussed the possible hypothesis and strategies in treatment.