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)

This ALCHEMIST trial studies genetic testing in screening patients with stage IB-IIIA non-small cell lung cancer that has been or will be removed by surgery. Studying the genes in a patient's tumor cells may help doctors select the best treatment for patients that have certain genetic changes.

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