Int J Med Sci 2019; 16(7):981-989. doi:10.7150/ijms.34739 This issue
1. Pathology Unit, University of Campania “L. Vanvitelli”, Naples, Italy.
2. Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples, Italy.
3. Medical Oncology, Department of Precision Medicine, University of Campania “L. Vanvitelli”, Naples, Italy.
4. Pathology Unit, Hospital S. Maria delle Croci, Azienda Romagna, Ravenna, Italy.
Molecular heterogeneity is a frequent event in cancer responsible of several critical issues in diagnosis and treatment of oncologic patients. Lung tumours are characterized by high degree of molecular heterogeneity associated to different mechanisms of origin including genetic, epigenetic and non-genetic source. In this review, we provide an overview of recognized mechanisms underlying molecular heterogeneity in lung cancer, including epigenetic mechanisms, mutant allele specific imbalance, genomic instability, chromosomal aberrations, tumor mutational burden, somatic mutations. We focus on the role of spatial and temporal molecular heterogeneity involved in therapeutic implications in lung cancer patients.
Keywords: lung cancer, molecular heterogeneity, therapy, driver mutations