Lung adenocarcinoma arising in individuals who have never smoked is understudied, represents a substantial global health burden, and is genomically distinct from smoking-associated disease. Zhao and colleagues have identified transcriptomic subtypes with prognostic value, including in stage I disease, supporting phenotypic state as an important determinant of outcome for lung adenocarcinoma in individuals who have never smoked. See related article by Zhao et al., p. 460.
Azizi et al. (2026) studied this question.