Tumour agnostic treatment is a genomically-informed treatment strategy that enriches for novel targets regardless of histological origin. This treatment typically fulfils the following criteria [1]:
- Tumours are enriched for ≥1 molecular alteration.
- Alterations are likely to predict response to a therapy.
- Alterations are found across a variety of cancers.
The following table summarises the key differences between development of a tumour-agnostic treatment (assessed in “basket trials”) versus traditional approval of cancer therapies [1-3].
Table 2: Tumour-Agnostic Treatment Versus Traditional Cancer Therapies
Tumour-agnostic treatment |
Traditional cancer therapies |
|
---|---|---|
Basis of approval |
|
|
Patient population |
|
|
In May 2017, the first approval of a tumour-agnostic treatment (pembrolizumab for tumours deficient in mismatch repair or with high microsatellite instability) was received [5]. Since then, other such approvals have followed including those for NTRK inhibitors larotrectinib and entrectinib, dorstarlimab (an anti-PD-1 antibody) and the combination of dabrafenib and trametinib in for BRAF V600E gene mutated cancers.
References
- Offin M, Liu D, Drilon A. Tumor-Agnostic Drug Development. J Clin Oncol 2018; 286-295.
- Remon J, Dienstmann R. Precision oncology: separating the wheat from the chaff. ESMO Open 2018; 3: e000446.
- Flaherty KT, Le DT, Lemery S. Tissue-Agnostic Drug Development. Am Soc Clin Oncol Educ Book 2017; 38: 222-230.
- Looney AM, Nawaz K, Webster RM. Tumour-agnostic therapies. Nat Rev Drug Discov. 2020 Jun;19(6):383-384.
- Davis AA, McKee AE, Kibbe WA, Villaflor VM. Complexity of Delivering Precision Medicine: Opportunities and Challenges. Am Soc Clin Oncol Educ Book 2018; 38: 998-1007.