Non-Smoking Lung Cancer Essential Update Archive

BTOG, in partnership with the Ruth Strauss Foundation, welcomed clinicians, researchers and patient advocates for a dedicated Essential Update focused on non-smoking lung cancer. The day brought together leading experts to explore causes, diagnosis, and the latest advances in treatment — all united by a shared commitment to improving outcomes for people affected by this disease.

Welcome & Opening Remarks

The meeting opened with a warm welcome from BTOG Chair Dr Tom Newsom-Davis, who set the tone for a collaborative and forward-looking day.

Dr Martin Forster introduced the work of the Ruth Strauss Foundation and challenged delegates to consider the importance of language in healthcare. His thought-provoking reflections on how we label “non-smoking lung cancer” highlighted the impact terminology can have on stigma, research focus, funding priorities and patient support.

Session 1: Cause and Identification

This session examined what we know — and what we are still learning — about the causes and early identification of non-smoking lung cancer.

• Prof Neal Navani presented global epidemiological data, exploring incidence trends and demographic patterns. His talk highlighted the growing recognition of lung cancer in people who have never smoked and the need for tailored research strategies.
• Dr Eva Gronroos focused on environmental risk factors, from air pollution to occupational exposures. The discussion reinforced the importance of public health policy and environmental protections in lung cancer prevention.
• Prof David Baldwin examined the evolving landscape of multi-cancer early detection (MCED) tests, questioning whether these tests could complement or challenge existing lung cancer screening pathways.

Together, the session underscored the complexity of causation and the need for refined approaches to risk assessment and early detection.

Session 2: Diagnosing Better and Faster

Timely and accurate diagnosis was the focus of the second session, which combined clinical expertise with lived experience.

• Charlotte Maxwell and Gini Harrison shared powerful patient perspectives, reminding the audience that diagnostic speed, clarity and sensitivity profoundly affect patient wellbeing.
• Dr Matthew Krebs compared liquid biopsies with traditional tissue biopsies, outlining how advances in circulating tumour DNA (ctDNA) testing are reshaping diagnostic pathways.
• Dr David Moore demystified pathology reports, helping clinicians interpret increasingly complex molecular findings.
• Karen Peplow addressed the practicalities of implementing ctDNA testing in routine clinical practice, highlighting both opportunities and service-level challenges.

The discussion reflected a clear theme: diagnostic innovation must be matched by system readiness to ensure equitable access.

Session 3: Early and Locally Advanced Disease

The afternoon moved to treatment strategies in early-stage and locally advanced disease.

• Dr Yvonne Summers outlined evolving peri-operative strategies, including optimisation of systemic therapies around surgery.
• Dr John Conibear explored targeted treatment approaches in non-resectable disease, demonstrating how precision therapies are reshaping chemoradiotherapy paradigms.
• Dr Shobhit Baijal examined Molecular Residual Disease (MRD) testing, asking whether it is ready for routine use in lung cancer management and what evidence is still required.

This session highlighted the accelerating pace of change and the importance of integrating emerging evidence into multidisciplinary care.

Session 4: Advanced Disease

The final scientific session focused on advanced disease and the lived realities behind the data.

• Charlotte Maxwell returned to speak candidly about living with lung cancer, grounding the scientific discussions in patient experience.
• Prof Samreen Ahmed reviewed the latest advances in mutation-driven lung cancer, emphasising the progress of precision medicine.
• Dr Matthew Williams provided an update on brain metastases management, including advances in radiosurgery and important DVLA guidance considerations for patients.
• Dr Fiona McDonald closed the scientific programme by examining the evidence for local consolidative therapy — weighing survival benefits against the risk of overtreatment.