- **Diagnosis with unresolved questions:** An external review can help identify questions about pathology, staging, biomarkers, or treatment sequencing worth discussing.

Patients with progression may want to compare available approaches, trials, technologies, or supportive care without assuming they will be candidates.

Reports scattered across laboratories, hospitals, and imaging centres can make it difficult to understand the full case and prepare questions for another institution before making decisions.

Certain tumours require very specific teams, and an international search may broaden the institutions that could review the case.

The possibility of reviewing biomarkers or molecular profiles leads some families to request a carefully indicated additional evaluation.

Structured coordination can help the family organize information, costs, timelines, and next steps without presenting undue certainties.

- **Recent diagnosis:** Individuals who wish to confirm essential questions before starting or changing a plan indicated by their medical team, for individual physician evaluation.

Patients with relapse who need to compare possibilities and understand what history would be reviewed by specialists in China, for individual physician evaluation.

Cases that may require subspecialists, multidisciplinary review, or reinterpretation of pathology and imaging before any decision, for individual physician evaluation.

Individuals concerned about progression, resistance, or adverse effects who seek an additional evaluation without discontinuing local care, for individual physician evaluation.

Patients interested in learning whether additional molecular testing could be medically relevant and available for their case, for individual physician evaluation.

Relatives who need to consolidate documents, compare international pathways, and prepare clear questions for a specialist consultation, for individual physician evaluation.

- **Multidisciplinary second opinion:** May bring together perspectives from medical oncology, surgery, radiotherapy, pathology, and imaging when case complexity justifies it, according to individual physician evaluation.

Reinterpretation of slides, blocks, radiological studies, or reports may be requested to confirm relevant diagnostic data, according to individual physician evaluation.

When indicated, the utility of biomarkers, sequencing, or other tests may be explored to inform therapeutic conversations, according to individual physician evaluation.

A surgical team may review resectability, risks, and alternatives, subject to in-person evaluation, clinical condition, and available resources, according to individual physician evaluation.

The appropriateness of radiotherapy techniques may be evaluated based on location, prior treatments, cumulative dose, and clinical objectives, according to individual physician evaluation.

Specialists may analyze chemotherapy, targeted therapy, immunotherapy, or other strategies without guaranteeing indication, access, or response, according to individual physician evaluation.

- **Case reception:** We collect diagnosis, symptoms, goals, clinical urgency, and key questions via form, email, WhatsApp, or secure upload, with scope agreed in advance.

We organize reports, treatments, laboratory results, pathology, and imaging to reduce gaps and facilitate coherent medical review, with scope agreed in advance.

We prepare translations of selected documents when a Chinese institution or specialist needs them to assess the case, with scope agreed in advance.

We create a concise timeline with diagnosis, prior therapies, response, adverse effects, and currently pending decisions, with scope agreed in advance.

We research potentially relevant hospitals, departments, and specialists without claiming formal cooperation or guaranteed access, with scope agreed in advance.

We present possible pathways, missing documents, evaluation steps, and logistical considerations so the patient can decide, with scope agreed in advance.

When it adds value, we coordinate a paid consultation subject to case acceptance, availability, and professional scheduling, with scope agreed in advance.

If an institution agrees to proceed, we support medical itinerary, interpretation, appointments, admission, documentation, and post-discharge organization, with scope agreed in advance.