Patient Case #1: Newly Diagnosed Stage 3A NSCLC

This case explores optimal management of early-stage non–small cell lung cancer (NSCLC) requiring integrating imaging, laboratory findings, and molecular profiling to guide treatment decisions. Key considerations include evaluating imaging and lab results for disease staging, identifying actionable molecular markers beyond EGFR and ALK, and determining next steps such as surgical intervention or adjuvant therapy are discussed. Current NCCN guidelines recommend comprehensive biomarker testing, though gaps remain in implementation and standardization, including variability in testing for newer or less common targets. Endoscopic bronchial ultrasound (EBUS) is commonly used for nodal assessment, but challenges such as access, operator expertise, and tissue adequacy can impact results; mitigation strategies include multidisciplinary coordination and training. Post-surgical surveillance focuses on early detection of recurrence, while emerging therapies targeting PD-L1, ROS1, BRAF, and other pathways provide additional options. A personalized, evidence-driven approach is critical for optimizing outcomes in early-stage NSCLC.