Advances in non-small cell lung cancer (NSCLC) treatment have transformed care from a one-size-fits-all approach in the 1990s to highly personalized regimens today. Treatment now considers actionable mutations within the cancer and utilizes PD-L1 expression to guide the use of immunotherapy. These developments highlight significant progress in tailoring therapies to improve patient outcomes, reflecting the complexity and evolution of modern NSCLC treatment strategies.