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The authors of this editorial are patients, advocates and founders of communities representing people living with oncogene-driven non-small cell lung cancer (NSCLC). From the patient-advocacy perspective, we wish to stimulate debate and facilitate discussion among UK thoracic oncologists, surgeons and policymakers regarding the potential role of surgical local consolidation therapy (LCT) before disease progression in selected patients with stage IV oncogene-driven NSCLC. Such proactive surgical LCT (also called salvage surgery or conversion surgery) involves resection of the primary lung tumour site. The LCT may be expanded to locoregional therapy and involve systematic lymph node dissection or lobe-specific lymph node dissection. Furthermore, treatment of isolated distant lesions (oligometastases), such as brain or adrenal metastases, may be considered. The extent of the procedures is to be decided on an individual basis and tailored to the patient's specific needs.