Observational Trial to Predict Response to Immune Checkpoint Inhibitors in Metastatic Non-Small Cell Lung Cancer

Inclusion Criteria:

Written informed consent and HIPAA authorization for release of personal health information prior to registration.
Age ≥ 18 years at the time of consent.
ECOG ≤ 3.
Suspected of or diagnosed with non-small cell lung cancer (NSCLC).
Must be clinically able, at investigator discretion, to undergo additional core needle biopsy passes (up to four) during their biopsy from a tumor site that yields a biopsy of at least 10 mm in length, and ideally longer. These additional core needle biopsies will be collected from a metastatic site amenable to additional passes (e.g. liver or lymph nodes). Core needle biopsy passes may also be collected from the primary tumor site (lung) if it can be accessed at no risk of pneumothorax (e.g., large, lateral tumor), and the site is amenable to additional passes per the clinical investigator.
Must be eligible based on investigator discretion to receive ICI monotherapy or combination therapy (e.g., combining two ICIs such as anti-PD-1 plus anti-CTLA-4) or ICI therapy in combination with chemotherapy or genome-targeted therapy; Must be treatment-naïve at the time of biopsy if newly diagnosed; If patient had Stage I, II, or III cancer and have progressed to metastatic they cannot have received any anti-cancer treatment for at least 2 months prior to biopsy.
Must plan to receive standard of care systemic anti-cancer treatment after the biopsy.
Must have measurable disease according to RECIST 1.1.
Participants with a secondary cancer diagnosis are eligible to participate, if participation does not interfere with systemic anti-cancer standard of care treatment for Non-Small Cell Lung Cancer.

Exclusion Criteria:

Any Lung cancer patient for whom an extra biopsy might pose a clinical risk, either due to not having liver, lymph node metastases or for any other reason.
Any (mental) impairment that would render the participant unable to understand his/her participation in the study.
Auto-immune disease that would render them ineligible for immune-oncology treatment.
Immunocompromised state due to disease (e.g., HIV) or medication (e.g., transplant).
Participants enrolled in another interventional clinical trial are not eligible. Participants involved in other observational trials not interrupting standard of care can participate in this study. Participants that take part in another interventional clinical trial prior to failing frontline treatment during their participation in the study will no longer be eligible and, therefore, discontinued.
Participants who are pregnant are not eligible.
Participants with relapsing Stage IV lung cancer who are undergoing or plan to undergo a second line of treatment are not eligible.