Advancing Non-Small-Cell Lung Cancer Management Through Multi-Omics Integration: Insights from Genomics, Metabolomics, and Radiomics.

The integration of multi-omics technologies is transforming the landscape of cancer management, offering unprecedented insights into tumor biology, early diagnosis, and personalized therapy. This review provides a comprehensive overview of the current state of omics approaches, with a particular focus on the application of genomics, NMR-based metabolomics, and radiomics in non-small cell lung cancer (NSCLC). Genomics currently represents one of the most established omics technologies in oncology, as it enables the identification of genetic alterations that drive tumor initiation, progression, and therapeutic response. Interestingly, genomic analyses have revealed that many tumors harbor mutations in genes encoding metabolic enzymes, thus establishing a tight connection between genomics and tumor metabolism. In parallel, metabolomics profiling-by capturing the metabolic phenotype of tumors-has, in recent years, identified specific biomarkers associated with tumor burden, progression, and prognosis. Such findings have catalyzed growing interest in metabolomics as a complementary approach to better characterize cancer biology and discover novel diagnostic and therapeutic targets. Moreover, radiomics, through the extraction of quantitative features from standard imaging modalities, captures tumor heterogeneity and contributes predictive information on tumor biology, treatment response, and clinical outcomes. As a non-invasive and widely available technique, radiomics has the potential to support longitudinal monitoring and individualized treatment planning. Both metabolomics and radiomics, when integrated with genomic data, could support a more comprehensive understanding of NSCLC and pave the way for the development of non-invasive, predictive models and personalized therapeutic strategies. In addition, we explore the specific contributions of these technologies in enhancing clinical decision-making for lung cancer patients, with particular attention to their potential in early diagnosis, treatment selection, and real-time monitoring.