I live in the Washington, DC metro area. Kaiser has standing agreements with a variety of cancer research centers, including Johns Hopkins and NIH.Terms of referrals for second opinions vary by your "plan." Medicare patient benefits are different from Federal Employee Health Benefit (FEHB) members. Because my onc didn't think my case warranted a second opinion, I paid out of pocket to see the FABULOUS Dr. Charles Rudin at Johns Hopkins and it was the best $600 I will ever spend.
Your local Kaiser team has a "Clinical Trials Coordinator" who, at your doctor's request, will "work up" specific clinical trial referrals on your behalf. Kaiser won't typically approve a Phase ! trial, except under special circumstances (like you're out of all other options but a VERY promising trial like the emerging work on immunological treatment paths). But Kaiser did approve the Phase1/1b BIBW/cetuximab trial for me. Patient safety and potential efficacy loom large in their decision process. And Kaiser will negotiate an agreement with a clinical trial study site that is not one of its routine partners. My wonderful clinical trial coordinator got all the way to the end of the process with the folks at Vanderbilt for the BIBW trial, when the MSKCC folks finally got it together so that I could participate there instead (easier commute via Amtrak).
The molecular testing is part of ongoing clinical studies under the Lung Cancer Consortium: Study 09-C-0103C (Prospective Analysis of Genotypes in Adults Undergoing Therapy for Lung Cancer) and Study #11-C-0096 (Pilot Trial of Molecular Profiling and Targeting Therapy for Advanced NSCLC, SCLC and Thymic Malignancies. Depending on the outcome of the testing, Dr. Giaccone and his team will recommend the most appropriate clinical trial option for me.
Potentially, 3 options in play: a MEK inhibitor trial at NIH, Dr Spigel's PD-1/PD-2 studies in Nashville, and the potential Phase 3 trial at Johns Hopkins that was reported by Dr Braehmer