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018), such as MET or ERBB2 amplification, and small cell lung cancer transformation. In the validation cohort, we found that patients with low T790M RAF (20%) had significantly lower objective response rates (ORRs) (0 68.8%, P=0.03) and disease control rates (DCRs) (60% 100%, P=0.048) in response to osimertinib compared to patients with high T790M RAF. In patients with progressive NSCLC post 1 generation EGFR-TKI treatment, plasma T790M RAFs of less than 20% can be used to identify patients who carry concurrent resistance mechanisms,