Using Ex Vivo Tumoroids To Predict Immunotherapy Response In NSCLC

Inclusion Criteria: * Ability of participant OR Legally Authorized Representative (LAR) to understand this study, and participant or LAR willingness to sign a written informed consent * Patients with advanced/metastatic NSCLC * Must be immunotherapy naive * Males and females age ≥ 18 years * ECOG Performance Status 0 - 2 * Measurable disease by RECIST 1.1 * Must have a lesion (either primary or metastatic lesion) that can be safely biopsied to have sufficient tissue (at minimum, 3-4 cores using 20g or larger core biopsy) to generate tumoroids * Must have at least one target lesion to evaluate treatment response * Will be receiving anti-PD-1/L1 with or without anti-CTLA-4 per standard of care Adequate organ function defined per standard of care in this setting. * Women of child-bearing potential and men with partners of child-bearing potential must agree to practice sexual abstinence or to use the forms of contraception as required/recommended by each immune checkpoint inhibitor used in the setting of standard of care. Exclusion Criteria: * Incarcerated * Not competent to make medical decision, noncommunicative or noncompliant per investigator's judgement.