Rapid advances in cancer genetics and genomics, pathophysiology, diagnostics, and therapeutics have substantially increased the complexity of clinical oncology. Integrating large and diverse data streams into timely, patient-specific decisions provides a compelling rationale for incorporating artificial intelligence (AI) into cancer care. Generative artificial intelligence (GenAI) encompasses several classes of models capable of generating new content. This clinically focused review concentrates on GenAI applications based primarily on large language models (LLMs) and vision-language models (VLMs), as well as emerging agentic systems that use these models to perform coordinated, multistep tasks. LLMs demonstrate substantial medical knowledge, strong performance on oncology-related assessments, and emerging capabilities in clinical reasoning. Guideline- and retrieval-augmented systems can improve concordance with expert recommendations and interpretation of complex treatment algorithms. LLMs and VLMs have been applied to documentation, patient communication, information extraction and summarization, clinical decision support, and multimodal data synthesis. However, performance varies substantially across tasks and clinical domains, with important limitations including incomplete or outdated information, training-data bias, automation bias, and confabulation. Agentic AI represents an emerging extension of these technologies in which LLMs or VLMs are incorporated into systems capable of multistep planning, external information retrieval, specialized tool use, and iterative evaluation and refinement. Early oncology applications include evidence synthesis, multimodal clinical decision support, radiology, pathology, surgery, and individualized treatment planning. With rigorous validation, transparent implementation, continual updating, and appropriate expert oversight, GenAI may augment oncologists' judgment, improve patient understanding and experience, streamline cancer care delivery, and advance personalized oncology.

Accurate classification of lung tumors in cytology specimens and small biopsies remains a diagnostic challenge because of limited cellularity, preanalytical variables, and significant morphologic overlap among entities. This review summarizes key cytomorphologic characteristics and practical immunocytochemical strategies, and common diagnostic pitfalls encountered in the evaluation of non-small cell lung carcinoma, small cell lung carcinoma, neuroendocrine tumors, secondary pulmonary neoplasms, and uncommon thoracic entities in endobronchial ultrasound-guided transbronchial needle aspiration and fine-needle aspiration samples. Particular emphasis is placed on the appropriate use of limited immunohistochemical panels to optimize tumor subtyping while preserving material for molecular testing. Diagnostic challenges such as crush artifact, necrosis, reactive mimics, overlapping morphologic patterns, and the risk of misclassification of rare tumors are addressed with practical guidance for differential diagnosis. By integrating morphologic assessment with ancillary testing, cytopathologists can achieve accurate tumor subtyping, distinguish mimics, and provide precise diagnoses that guide clinical management and selection of targeted therapies.

The BRCA1 and BRCA2 tumor suppressor genes are integral to the repair of DNA double-strand breaks. Therefore, germline pathogenic variants (PVs) in either of these genes are associated with an increased risk of developing hereditary cancers. For over 30 years, studies have demonstrated a well established and markedly increased lifetime risk of female breast cancer and ovarian cancer for individuals with a PV in BRCA1 or BRCA2. Additional canonical cancers include prostate cancer, pancreatic cancer for males and females, and male breast cancer. Several noncanonical cancers have also been reported in association with BRCA1 or BRCA2, including stomach cancer and endometrial cancer. This review summarizes the established and evolving cancer risks associated with germline PVs in BRCA1 or BRCA2 as well as current clinical management recommendations. With increased uptake and diversified utility of germline genetic testing, this summary provides a current overview for clinical management of both male and female individuals with a PV in BRCA1 or BRCA2.