“…This special issue of Genome Medicine highlights the advances made in understanding how compromised genome integrity impacts genome architecture, tumor biology, immune escape, and the mechanisms underlying differential response and resistance to cancer therapies, outlining new avenues for precision therapies and clinical decision-making. For example, at base pair resolution, a high frequency of SNVs with characteristic C > A and T > C mutations, together with a high degree of indel formation at polynucleotide repeat tracts (also termed microsatellite instability), has been found in tumors with mismatch repair deficiencies (MMRd) [7]. It is important to detect tumors that have MMRd because of their reported sensitivities to immunotherapy [8, 9], regardless of the cell of origin.…”