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Recent years have seen substantial advances in lung cancer management, with therapeutic options expanding rapidly through the integration of targeted therapies, immunotherapies, antibody-drug conjugates, and novel, immune-engaging agents. Although outcomes have improved for selected patients with non-small cell lung cancer and small cell lung cancer, the increasing number of regimens has amplified clinical complexity, with persistent evidence gaps, limited head-to-head comparisons, and underrepresentation of key subgroups in trials. Emerging genomic tools and novel therapeutic modalities provide opportunities to further improve patient outcomes but also add to the challenges of clinical decision-making. To address these issues, a multidisciplinary panel of oncology experts, primarily based in the United States, convened to review current evidence gaps, controversies, and unmet needs in the management of lung cancer. Key areas were identified in treatment selection and sequencing as well as the management of high-risk subtypes, highlighting the need for prospective, head-to-head clinical trials. Findings from this panel will inform a 2026 follow-up conference in which a modified Delphi method will be used to develop formal consensus recommendations to provide actionable guidance for practicing clinicians.