Torres, William

45-year-old never-smoker with ALK-rearranged (EML4-ALK variant 1) stage IIIB NSCLC, leptomeningeal carcinomatosis detected on MRI, CSF cytology positive. Lorlatinib at full dose (100mg daily) vs. intrathecal therapy consideration. Evaluate CNS response assessment strategy and role of whole-brain radiation.

Perioperative strategy — neoadjuvant nivolumab + chemo followed by adjuvant nivolumab.

MET exon 14 skipping — capmatinib vs. tepotinib first-line selection.

MET exon 14 skipping — capmatinib vs. tepotinib first-line selection.

First-line osimertinib management with concurrent CNS metastases — systemic vs. local therapy.

Resistance mechanism workup after progression on osimertinib — liquid biopsy vs. tissue rebiopsy.

Perioperative strategy — neoadjuvant nivolumab + chemo followed by adjuvant nivolumab.

ALK rearranged — first-line alectinib vs. lorlatinib given CNS involvement.

KRAS G12C — sotorasib vs. adagrasib in second-line, STK11 co-mutation impact.

PD-L1 >= 50% without driver — pembrolizumab monotherapy vs. chemo-IO combination.

MET exon 14 skipping — capmatinib vs. tepotinib first-line selection.

PD-L1 >= 50% without driver — pembrolizumab monotherapy vs. chemo-IO combination.

KRAS G12C — sotorasib vs. adagrasib in second-line, STK11 co-mutation impact.

Stage IB resected adenocarcinoma — adjuvant osimertinib eligibility with EGFR mutation.

Stage IB resected adenocarcinoma — adjuvant osimertinib eligibility with EGFR mutation.

Perioperative strategy — neoadjuvant nivolumab + chemo followed by adjuvant nivolumab.

Resistance mechanism workup after progression on osimertinib — liquid biopsy vs. tissue rebiopsy.

Resistance mechanism workup after progression on osimertinib — liquid biopsy vs. tissue rebiopsy.