Thoracic Oncology

Thoracic oncology is a subspecialty of oncology which supports thoracic surgeons in the care of patients with cancers of the chest (lung cancer, thymoma, mesothelioma). Drug therapy for lung cancer improves overall survival in patients with stage IV disease (palliative drug therapy) and improves rates of cure when combined with surgery, or radiation therapy, for stages II–III (adjuvant, neoadjuvant, consolidation therapy). Contemporary practice requires routine use of molecular pathology tests to identify clinically relevant subtypes of non-small cell lung cancer (NSCLC) most likely to respond to oncogene-targeted drugs and immune checkpoint inhibitors. Important drug-defined subtypes of NSCLC include EGFR mutant, ALK positive, ROS1 positive, HER2 mutant, BRAF V600E, KRAS G12C, NTRK positive, RET positive, METe14 positive, NRG1 positive, MET amplified, and PDL1 high.