Jimmy Ruiz, MD, reflects on his career journey in North Carolina and the transformative progress in lung cancer treatment. Early in his career, limited tools like chemotherapy presented challenges. Today, advancements such as biomarker-driven therapies, including EGFR inhibitors and PD-L1 checkpoint inhibitors, have revolutionized patient care. Dr. Ruiz emphasizes the critical role of targeted therapies, the growing application of liquid biopsies, and the importance of molecular testing in improving outcomes. With declining lung cancer mortality and an expanding arsenal of FDA-approved treatments, he envisions a future of continued progress in personalized oncology.