45 - The Molecular Biology of Thoracic Malignancies

Abstract

For decades, thoracic malignancies were associated with poor prognosis. Treatments were marginally helpful in these cancers with abundant genetic diversity. Tremendous advancements in our understanding of the oncogenesis and metastasis of thoracic cancers have revolutionized diagnosis and treatment. Modern molecular and analytic technologies allowed the identification of key and potentially targetable genetic, transcriptomic, epigenetic, and proteomic aberrations and the characterization of the effect of tumor microenvironment on cancer progression. The advent of targeted therapeutics has led to significant improvements in patient outcomes and individualization of care. However, current therapies do not always have an effective or long-lasting response in every patient. Despite what we have learned over the last several decades, cancer is not yet completely understood. It is critical to deepen and rigorously validate our knowledge of thoracic tumor biology to identify predictors of durable response and to develop novel therapeutics with the hope of more consistent and predictable outcomes. Here, we provide a review of the current understanding of molecular mechanisms and biology of thoracic malignancies and the role of multiomics, biomarkers, and personalized oncology in changing the paradigms of treatment.