RT Book, Section A1 Said, Rabih A1 Tsimberidou, Apostolia-Maria A2 Kantarjian, Hagop M. A2 Wolff, Robert A. A2 Rieber, Alyssa G. SR Print(0) ID 1190839318 T1 Targeted Therapy in Cancer T2 The MD Anderson Manual of Medical Oncology, 4e YR 2022 FD 2022 PB McGraw Hill Education PP New York, NY SN 9781260467642 LK hemonc.mhmedical.com/content.aspx?aid=1190839318 RD 2024/03/28 AB KEY CONCEPTSThe therapeutic approach for patients with metastatic cancer includes multigene tissue genomic analysis and assessment of immune markers that include programmed cell death-ligand 1, microsatellite instability (MSI) status, tumor mutational burden, neurotrophic tyrosine kinase receptor (NTRK) fusion, human epidermal growth factor receptor 2 (HER2) amplification, and cell-free DNA analysis to identify drivers of carcinogenesis. The use of targeted therapy against molecular alterations in individual patients has been associated with improved clinical outcomes.Patients with advanced cancer may have tumor molecular alterations in one or more of the following genes and pathways: RAS-RAF-MEK, PI3K-AKT-mTOR, EGFR, HER-2, BRCA, HER2, RET, ROS-1, KIT, CDK4/6, PDGFR, VEGFR1/2/3, PDGFRα, NTRK, METex1h4, FGF, Trop-2 CSF1R, AR, ER, and other genes. (See text for abbreviations.)Larotrectinib and entractinib are novel NTRK inhibitors indicated for patients whose tumor has a NTRK fusion, irrespective of tumor type.Treatment with pembrolizumab (a programmed cell death protein 1 inhibitor) is indicated for patients with MSI-H mismatch repair deficient tumors irrespective of tumor type.The combination of targeted therapy with either chemotherapy or immunotherapy has shown promising results in various tumors. Prospective trials are warranted to provide biomarkers associated with response or resistance to immunotherapeutic agents.Novel drug development, complete understanding of mechanisms of carcinogenesis, innovative clinical trials, and harmonization of policy and practice will accelerate the implementation of personalized medicine.