Genetic Testing in Screening Patients With Stage IB-IIIA Non-small Cell Lung Cancer That Has Been or Will Be Removed by Surgery (The ALCHEMIST Screening Trial)

Inclusion Criteria:

   - PATIENT PRE-REGISTRATION ELIGIBILITY CRITERIA:

   - For pre-surgical patients

      - Suspected diagnosis of resectable non-small cell lung cancer; cancers with a
      histology of "adenosquamous" are considered a type of adenocarcinoma and thus a
      "nonsquamous" histology; patients with squamous cell carcinoma are eligible

      - Suspected clinical stage of IIIA, II (IIA or IIB) or large IB (defined as size >=
      4 cm); Note: IB tumors < 4 cm are NOT eligible; stage IB cancer based on pleural
      invasion is not eligible unless the tumor size is >= 4 cm; the 7th edition of
      American Joint Committee on Cancer (AJCC) staging will be utilized

   - For post-surgical patients

      - Completely resected non-small cell lung cancer with negative margins (R0);
      patients with squamous cell carcinoma are eligible only if they have not received
      adjuvant therapy

      - Pathologic stage IIIA, II (IIA or IIB) or large IB (defined as size >= 4 cm);
      Note: IB tumors < 4 cm are NOT eligible; stage IB cancer based on pleural
      invasion is not eligible unless the tumor size is >= 4 cm; the 7th edition of
      AJCC staging will be utilized

   - Eastern Cooperative Oncology Group (ECOG) performance status 0-1

   - Age ≥ 18 years

   - No patients who have received neoadjuvant therapy (chemo- or radio-therapy) for this
   lung cancer

   - No locally advanced or metastatic cancer requiring systemic therapy within 5 years
   prior to registration; no secondary primary lung cancer diagnosed concurrently or
   within 2 year prior to registration

   - No prior treatment with agents targeting EGFR mutation, ALK rearrangement, and
   PD-1/PD-L1/CTLA-4

   - No patients known to be pregnant or lactating

   - Patients who have had local genotyping are eligible, regardless of the local result

   - No patients with recurrence of lung cancer after prior resection

   - Note: Post-surgical patients should proceed to registration immediately following
   preregistration

   - PATIENT REGISTRATION ELIGIBILITY CRITERIA:

   - Tissue available for the required analyses (either clinical tissue block or slides and
   scrolls)

   - Completely resected NSCLC with negative margins (R0); cancers with a histology of
   "adenosquamous" are considered a type of adenocarcinoma and thus a "nonsquamous"
   histology

   - Pathologic stage IIIA, IIA or IIB, or large IB (defined as size >= 4 cm); Note: IB
   tumors < 4 cm are NOT eligible; stage IB cancer based on pleural invasion is not
   eligible unless the tumor size is >= 4 cm; the 7th edition of AJCC staging will be
   utilized

   - Patients with squamous cell carcinoma are eligible only if they have not received
   adjuvant therapy

   - In order to allow for time for central genotyping and eligibility for the ALCHEMIST
   treatment trial, patients must register within the following eligibility windows:

      - Squamous patients:

         - No adjuvant therapy permitted, register patient within 77 days following
         surgery

      - Non-squamous patients:

         - If no adjuvant therapy, register patient within 75 days following surgery

         - If adjuvant chemotherapy or radiotherapy only, register patient within 225
         days following surgery

         - If adjuvant chemotherapy and radiation, register patient within 285 days
         following surgery