131P Clinical impact of tumor-infiltrating clonal hematopoiesis of indeterminate potential (TI-CHIP) in advanced non-small cell lung cancer (NSCLC)

7.4 months; p=0.038) and a trend toward improved OS (17.1 vs 10.2 months; p=0.055).Multiple-organ involvement was associated with inferior OS (median 10.3 vs 22.0 months; p=0.001) and WFFS (7.4 vs 15.8 months; p=0.004).A low-risk progression group defined by lower DMV and single-organ involvement demonstrated significantly longer OS (22.0 vs 10.3 months; p=0.0013) and WFFS (15.8 vs 7.4 months; p=0.0035) vs high-risk progression.Higher DMV was associated with enrichment of EZH2 (9% vs 0%) and MYC alterations (9% vs 0%), increased NRF2 pathway alterations (27% vs 9%; p=0.04).Conclusions: DMV and a simple progression risk score integrating DMV and organ involvement provide quantitative prognostic stratification after oligometastatic progression in NSCLC.Distinct genomic correlates associated with higher DMV suggest underlying biological drivers of metastatic trajectories.These accessible metrics may support patient selection for local therapy and prospective trial stratification.