Within the framework of the existing paradigm of combined treatment, it is possible to identify groups of patients whose chances of cure range from 75 to 90% for certain nosologies, the prevalence of the process, primary response, radicality of the operation, and in some cases for the receptor repertoire and characteristic changes in the tumor cell genome: hematologic malignancies, some solid tumors. However, the modern concept of treatment based on chemotherapy has fully realized its potential. New chemotherapeutic agents do not meet the expectations placed on them. Targeted drugs, CAR T-cells, various cytokines, and checkpoint inhibitors have entered the practice of an oncologist. The creation and implementation of a «golden immunological bullet» that destroys only tumor cells, controls relapse, and does not damage healthy tissues, unfortunately, is impossible due to the lack of specific target receptors on malignant cells and their biological heterogeneity. The concept of a «golden bullet,» if at all possible, implies personalized medicine, as it is unlikely that targets common to all patients, even with similar tumor types, can be identified. The introduction of immune checkpoint inhibitors (ICI) into practice is a step towards forming an innovative treatment paradigm, although it does not solve many issues related to the effectiveness of drugs for different types of tumors and their acute and delayed toxicity.