Document is current

Article History

Received: 21 November 2024

Accepted: 4 February 2026

First Online: 18 May 2026

Competing interests

: M.A. reports fees from Neuroute, FutureHouse and Edison Scientific, unrelated to this work. M.A., N.R.N. and C.S. are named as inventors of the patent PCT/EP2025/086701 relating to the use of plasma proteomics for risk prediction of lung cancer (unrelated to this paper). They are also listed as inventors on a patent application (GB) that has been filed but is not related to the method described in this paper. The application is currently unpublished and remains within the priority year. R.V. declares research funding from CRUK TDL–Ono–LifeArc alliance and Genesis Molecular AI. A.C. is a consultant for Tempus Labs. S.T. reports personal fees from Roche, Novartis, AstraZeneca and Ipsen outside the submitted work; and the following patents filed: indel mutations as a therapeutic target and predictive biomarker (PCTGB2018/051892 and PCTGB2018/051893) and clear-cell renal cell carcinoma biomarkers (P113326GB). N.M. has stock options in and has consulted for Achilles Therapeutics and holds a European patent in determining HLA LOH (PCT/GB2018/052004), a patent pending in determining HLA disruption (PCT/EP2023/059039) and is a co-inventor to a patent to identify responders to cancer treatment (PCT/GB2018/051912). C.S. acknowledges grant support from AstraZeneca, Boehringer-Ingelheim, Bristol Myers Squibb, Pfizer, Invitae (previously Archer Dx—collaboration in minimal residual disease sequencing technologies), Ono Pharmaceutical, and Personalis. He is also Co-Chief Investigator of the NHS Galleri trial funded by GRAIL and a paid member of GRAIL’s Scientific Advisory Board. He was Chief Investigator for the AZ MeRmaiD 1 and 2 clinical trials and the Steering Committee Chair. C.S is a paid board member for Novartis from March 2026. He is also a paid board member for Bicycle Therapeutics and is Chair of the Clinical Advisory Group. He receives consultant fees from Genentech, Medicxi, China Innovation Centre of Roche (CICoR) formerly Roche Innovation Centre – Shanghai, Relay Therapeutics (SAB member), Saga Diagnostics (SAB member), and Sarah Cannon Research Institute. He previously received consultant fees from Achilles Therapuetics. C.S has received honoraria from Amgen, AstraZeneca, Bristol Myers Squibb, GlaxoSmithKline, Illumina, MSD, Novartis and Pfizer. C.S. has equity in Bicycle Therapeutics. He has stock options in Novartis, Relay Therapeutics, Saga Diagnostics and Bicycle Therapeutics. He has previously held stock and was co-founder of Achilles Therapeutics. C.S declares a patent application for methods to lung cancer (PCT/US2017/028013); targeting neoantigens (PCT/EP2016/059401); identifying patent response to immune checkpoint blockade (PCT/EP2016/071471); methods for lung cancer detection (US20190106751A1); identifying patients who respond to cancer treatment (PCT/GB2018/051912); determining HLA LOH (PCT/GB2018/052004); predicting survival rates of patients with cancer (PCT/GB2020/050221); methods and systems for tumour monitoring (PCT/EP2022/077987); analysis of HLA alleles transcriptional deregulation (PCT/EP2023/059039); relating to the use of plasma proteomics for risk prediction of lung cancer (PCT/EP2025/086701). C.S. is an inventor on a European patent application (PCT/GB2017/053289) relating to assay technology to detect tumour recurrence. This patent has been licensed to a commercial entity and under their terms of employment C.S is due a revenue share of any revenue generated from such license(s). K.L. has the following disclosures (all unrelated to the current work): patent on indel burden and CPI response pending, patent on ctDNA minimal residual disease calling methods, patent pending on a lung cancer vaccine; speaker fees from Roche Tissue Diagnostics and Ellipses Pharma; research funding from CRUK TDL/Ono/LifeArc alliance and Genesis Therapeutics; and consulting roles with Monopteros Therapeutics, Saga Diagnostics, Kynos Therapeutics and Tempus Labs. Again unrelated to this work, K.L. is currently employed by Isomorphic Labs. The other authors declare no competing interests.