∙ Any patient who is undergoing double lung transplantation as part of the clinical program, consents for this prospective observational trial, and has one of the following conditions will be eligible.

• Common Inclusion Criteria

‣ Adults of Age ≦ 80

⁃ Resistant or refractory to or without available standard of care treatment options or experimental treatment options that are known to increase survival outcome

⁃ Patients without any extrapulmonary disease

⁃ Patients with good general health with an ability to withstand physiologic stressors and undergo psychosocial evaluation by the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) or other assessment tools

⁃ Patients to meet all other criteria for lung transplantation including insurance approval and United Network for Organ Sharing (UNOS) registration

• Histologically confirmed selected lung non-small cell lung cancer including but not limited to:

• o according to the International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification

• \- Lepidic dominant pattern

• Adenocarcinoma in situ

• Minimally invasive adenocarcinoma

• Non mucinous lepidic predominant invasive adenocarcinoma

• o based on 2015 World Health Organization (WHO) classification of lung tumors including

• \- Invasive mucinous adenocarcinoma

• Mixed invasive mucinous and mucinous adenocarcinoma

‣ Colloid adenocarcinoma

⁃ Enteric adenocarcinoma

⁃ Minimally invasive adenocarcinoma

• Nonmucinous

• Mucinous

• \- Preinvasive lesions

• Atypical adenomatous hyperplasia

• Adenocarcinoma in situ

‣ Nonmucinous

⁃ Mucinous

⁃ based on the 2004 WHO classification of lung tumors including - Bronchioloalveolar carcinoma

• Nonmucinous

• Mucinous

• Mixed nonmucinous and mucinous or indeterminate

• Without any distant metastasis confirmed by standard staging work-up

• Without brain metastasis confirmed by brain imaging

• Without unidentified primary site of cancer

• Metastatic cancers to lung alone - including but not limited to germ cell tumors, head \& neck tumors, colorectal tumors, renal cell tumors, testicular cancer

• Without any other distant metastasis confirmed by standard staging work-up

• Respiratory failure with a history of cancer in the last 5 years - including, but not limited to interstitial lung disease (ILD), pulmonary fibrosis (idiopathic or secondary), advanced chronic obstructive pulmonary disease (COPD), bronchiectasis, emphysema, cystic fibrosis (CF), emphysema due to alpha-1 antitrypsin deficiency, and pulmonary arterial hypertension (PAH)

• Without any other distant metastasis confirmed by standard staging work-up