Evaluation of Programmed Death Ligand 1 (PDL1) Response to Treatment in Extracellular Vesicles (EVs), Patient-derived Organoid (PDOs)s and Immune-marker Positron Emission Tomography (PET) Scanning in Non-small Cell Lung Cancer (NSCLC)

This trial is testing whether a predictive tool called a "patient-derived organoid" (PDO) — a mini-tumor grown in a lab from the patient's own cancer cells — can predict how well a patient with recurrent advanced non-small cell lung cancer (NSCLC) will respond to immunotherapy or chemotherapy as their first-line treatment. **You may be eligible if...** - You have been diagnosed with NSCLC that initially started at a resectable stage (Stage I–III) and has now returned as advanced or metastatic disease - You originally had your tumor removed by surgery - Your cancer recurrence has been confirmed by biopsy - You have at least one measurable lesion on a scan - Your doctor considers you suitable for first-line treatment with immunotherapy (with or without chemotherapy) - You have had tissue submitted for an attempt to grow PDOs in the lab - You are HIV-positive participants may be eligible if on stable antiretroviral therapy **You may NOT be eligible if...** - Your cancer did not start at a surgically resectable stage - Your cancer recurrence cannot be confirmed by biopsy - You are not a candidate for first-line systemic treatment Talk to your doctor to see if this trial is right for you.