A 60-year-old woman sees you for a second opinion. She developed a persistent cough and chest wall pain that led to chest imaging. She was found to have a right lower lobe mass, hilar, and mediastinal adenopathy. Fluorodeoxyglucose-PET imaging showed increased uptake in these areas, as well as in multiple locations throughout the skeleton, and a right adrenal nodule. A needle biopsy specimen of the adrenal nodule showed rare malignant cells compatible with adenocarcinoma of lung origin. Additional molecular testing was not able to be completed. She had been previously healthy without prior known chronic lung disease. She has a 10 pack-year smoking history, having quit 20 years ago.
Which would you recommend as the next step for this patient?
