Dr. Ricciuti presented Case 1, a 56-year-old with KRAS G12C metastatic lung cancer showed limited IO benefit; panel favored chemo-IO and clinical trials for this challenging mutation. Case 2, presented by Dr. Singhi, is a 55-year-old with metastatic squamous lung cancer and KRAS/STK11 mutations had an exceptional response to immunotherapy alone, prompting discussion of consolidation options. Dr. Gomez presented Case 3, a 95-year-old with recurrent mucinous lung cancer highlighted treatment choices, tolerance, quality of life, and limits of aggressive therapy in the very elderly. Case 4, presented by Dr. Kim, reviewed a 74-year-old with PD-L1–negative metastatic squamous lung cancer, high TMB, complex comorbidities, and debated systemic, IO, or surgical options. Dr. Karim presented Case 5, a 65-year-old with atypical lung carcinoid showed limited adjuvant benefit, later metastasis, octreotide response, evolving classification, and trial-based options. The wrap up session discussed managing oligo-progression on immunotherapy, favoring local therapy (SABR/surgery), individualized plans, IO continuation or rechallenge, and noting risk of new primaries.