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Article History

Received: 13 January 2025

Accepted: 5 February 2026

First Online: 18 March 2026

Competing interests

: M.J.-H. has consulted for Astex Pharmaceutical and Achilles Therapeutics, is a member of the Achilles Therapeutics Scientific Advisory Board and Steering Committee, and has received speaker honoraria from Pfizer, Astex Pharmaceuticals, Oslo Cancer Cluster, Bristol Myers Squibb and Genentech. M.J.-H. is listed as a co-inventor on a European patent application relating to methods to detect lung cancer (PCT/US2017/028013), this patent has been licensed to commercial entities and, under terms of employment, M.J.-H. is due a share of any revenue generated from such license(s), and is also listed as a co-inventor on the GB priority patent application (GB2400424.4) with title Treatment and Prevention of Lung Cancer . C.S. reports receiving support from the Francis Crick Institute and the Royal Society; has received grants or contracts from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Invitae (formerly Archer Dx), Ono Pharmaceuticals, Pfizer and Roche-Ventana; has received consulting fees from Bicycle Therapeutics, Genentech, Medicxi, Metabomed, Novartis, and is a member of the GRAIL SAB, Relay Therapeutics SAB, China Innovation Center of Roche (CICoR), SAGA Diagnostics SAB and the Sarah Cannon Research Institute; has received honoraria from Amgen, AstraZeneca, Bristol Myers Squibb, Illumina, GlaxoSmithKline, MSD, Roche-Ventana and Pfizer; holds patents, planned, issued, or pending, including PCT/GB2017/053289, PCT/EP2016/059401, PCT/EP2016/071471, PCT/GB2018/052004, PCT/GB2020/050221, PCT/GB2018/051912, PCT/US2017/28013 and PCT/GB2018/051892; has leadership or fiduciary roles with Cancer Research UK and AACR; holds stock or stock options in Apogen Biotech, Epic Biosciences, GRAIL and Achilles Therapeutics; and has other financial or non-financial interests with AstraZeneca and GRAIL Bio UK. M.T.L. reports grants research funding from the American Heart Association, AstraZeneca, Ionis, Johnson & Johnson Innovation, Kowa Pharmaceuticals America, MedImmune, National Academy of Medicine, the National Heart, Lung, and Blood Institute and the Risk Management Foundation of the Harvard Medical Institutions outside the submitted work. S.B. reports consulting fees from Ambient. H.J.W.L.A. reports consulting fees and/or stock from Onc.AI, Love Health, Sphera, Health-AI, Ambient, and AstraZeneca. N.J.B. reports consulting fees from Ambient, is listed as a co-inventor on a patent application (PCT/GB2020/050221) on methods for cancer prognostication and a patent on methods for predicting anti-cancer response (US14/466,208). The other authors declare no competing interests.