Agnostic markers of malignant neoplasms

Agnostic therapy opened the new era in the development of antitumor therapy schemes that take into account the molecular characteristics of the tumor and do not depend on its localization or histological type. In 2018, the FDA approved six drugs with indications that do not depend on the localization of the tumor: pembrolizumab (both for tumors with defects in the repair system of unpaired DNA nucleotides (dMMR)/ high microsatellite instability (MSI-H), and for tumors with a high tumor mutation burden (TMB-H)), dostarlimab (for tumors with dMMR), larotrectinib andentrectinib (for tumors containing gene translocations of neurotrophic receptor tyrosine kinase ( NTRK )) and a combination of dabrafenib with trametinib (for tumors with the V600 mutation in the BRAF gene).Although this approach may intuitively seem rational, one should not overlook the fact that it is impossible to accurately predict the effect of the drug in unexplored types of tumors. However, for a number of patients, this therapy may be the only opportunity to receive drugs not depending on the morphological type of the tumor, but on the fact of the presence of a molecular sign indicating a high chance of the response to therapy.