Treatment Response Adapted Hybrid Radiotherapy in Metastatic Non-small Cell Lung Cancer Receiving First-line Immunotherapy

This study is looking at a personalized radiation approach for patients with advanced (stage IV) non-small cell lung cancer receiving immunotherapy as their first treatment. Based on how well tumors respond after the first round of immunotherapy, radiation is added to specific tumor sites to try to improve overall outcomes. **You may be eligible if...** - You have been diagnosed with stage IV non-small cell lung cancer confirmed by biopsy - Your tumor has been tested and does not have the common driver mutations (EGFR, ALK, or ROS-1 positive) - Your general health score is 0 or 1 (ECOG), meaning you are active and able to care for yourself - If you have brain metastases, they must be stable and not causing symptoms - Your life expectancy is at least 3 months and your organ function is adequate **You may NOT be eligible if...** - Your tumor has EGFR, ALK, or ROS-1 mutations (these patients typically get targeted therapy instead) - You currently need immediate palliative radiation to any site - You have severe heart, kidney, liver, or bone marrow problems - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.