People with cancer are particularly vulnerable during this pandemic and are at high risk of developing a serious COVID-19-related illness. The data that are available suggest that patients with cancer, especially those who are undergoing treatment, are at a higher risk for severe COVID-19 infection and death. These patients need increased surveillance, screening, and better personal protection strategies. Patients with lung and esophageal cancers often require aggressive multidisciplinary treatment. In the era of the COVID-19 pandemic, we face new challenges in delivering systemic therapies (chemotherapy/targeted therapy/immunotherapy) to patients with thoracic malignancies. This review aims to highlight the common issues faced and measures that need to be taken to effectively deliver systemic therapy to patients with thoracic malignancies.