Abstract
As in every cancer, pulmonary tumours result from the accumulation of driver mutations, epigenetic changes and the organization of a favorable microenvironment that includes stromal, vascular and immune cells. The mechanisms that drive the oncogenesis of pulmonary epithelium have been largely studied and recent genomic studies such as TRACERx have brought new insights into this disease. Some mutations are associated with an oncogenic dependancy that can be specifically targeted. The clonal and sub-clonal evolution of a tumour will influence the natural history of the disease, the occurrence of local recurrence and metastatic tumours, the development of resistance to treatment, particularly to targeted therapy. In this review, we will focus on the processes that affect tumour cells and we will not discuss the tumour microenvironment, even if it plays a major role in tumour development and evolution.1877-1203/© 2023 SPLF. Published by Elsevier Masson SAS. All rights reserved.
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