Histology Specific Molecular Biomarkers: Ushering in a New Era of Precision Radiation Oncology

Philip Sutera, Heath Skinner, Matthew Witek, Mark Mishra, Young Kwok, Elai Davicioni, Felix Feng, Daniel Song, Elizabeth Nichols, Phuoc T. Tran, Carmen Bergom

Research output: Contribution to journalReview articlepeer-review


Histopathology and clinical staging have historically formed the backbone for allocation of treatment decisions in oncology. Although this has provided an extremely practical and fruitful approach for decades, it has long been evident that these data alone do not adequately capture the heterogeneity and breadth of disease trajectories experienced by patients. As efficient and affordable DNA and RNA sequencing have become available, the ability to provide precision therapy has become within grasp. This has been realized with systemic oncologic therapy, as targeted therapies have demonstrated immense promise for subsets of patients with oncogene-driver mutations. Further, several studies have evaluated predictive biomarkers for response to systemic therapy within a variety of malignancies. Within radiation oncology, the use of genomics/transcriptomics to guide the use, dose, and fractionation of radiation therapy is rapidly evolving but still in its infancy. The genomic adjusted radiation dose/radiation sensitivity index is one such early and exciting effort to provide genomically guided radiation dosing with a pan-cancer approach. In addition to this broad method, a histology specific approach to precision radiation therapy is also underway. Herein we review select literature surrounding the use of histology specific, molecular biomarkers to allow for precision radiotherapy with the greatest emphasis on commercially available and prospectively validated biomarkers.

Original languageEnglish
Pages (from-to)232-242
Number of pages11
JournalSeminars in Radiation Oncology
Issue number3
StatePublished - Jul 2023


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