Magy Onkol. 2020 Sep 23;64(3):206-215. Epub 2020 Aug 23.
More than 6 million mutations of more than 600 cancer genes can occur in over 200 tumor types according to the COSMIC (Catalogue of Somatic Mutations in Cancer) database. The theoretical combination of all "driver" alterations and tumor types adds up to an enormous number. Therefore, there is a legitimate need to use the same targeted therapy in the presence of its target and mechanism of action in multiple tumor types. The first tissue-agnostic drugs that are registered solely based on
molecular biomarkers are the NTRK inhibitors (larotrectinib and entrectinib) and the PD-1 inhibitor pembrolizumab in microsatellite instable (MSI) and tumor mutation burden (TMB) high tumors. These targets are also present in lung cancer, and we have clinical proof of the activity of treatments. In addition, the molecular targets of many targeted therapies registered in other tumor types occur in lung cancer for target-based tissue-agnostic therapy planning in lung cancer.