This retrospective cohort study included 2,833 patients with stage IB to IIIA NSCLC who enrolled in the Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trial (ALCHEMIST) screening study from August 18, 2014, to April 1, 2019. Although 93% received surgical resection, just 53% had adequate lymph node dissection and 57% received any adjuvant chemotherapy. The authors suggest more effort at optimizing use of proven therapies in this patient population.