SEOM clinical guideline on unknown primary cancer (2017)

Losa, Ferrán; Soler, G.; Casado, Antonio; Estival, Anna; Fernández, I.; Gimenez, S Elena; Longo, Federico; Pazo-Cid, Roberto; Salgado, Josefa; Seguí, M. Á.

doi:10.1007/s12094-017-1807-y

Cited by 62 publications

(77 citation statements)

References 29 publications

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“…However, in another study (GEFCAPI 04), where gene expression analysis was used to identify the most likely primary tumor, the best available targeted therapy and other treatments tailored to the primary tumor failed to improve disease progression or survival compared with chemotherapy [32]. For cancers of unknown primary origin taxanes are recognized as a chemotherapeutic option, so cabazitaxel could be a useful treatment option to be studied in these patients that have resistance to docetaxel [33,34]. Furthermore, it has been shown that patients with some specific subtypes of prostate cancer, such as luminal B (classified using gene expression signatures) experience significant improvements in time to castration resistance and overall survival following treatment with docetaxel plus androgen deprivation therapy (ADT) [35].…”

Section: Discussionmentioning

confidence: 99%

Effect of Baseline Characteristics on Cabazitaxel Treatment Duration in Patients with Metastatic Castration-Resistant Prostate Cancer: A Post Hoc Analysis of the Compassionate Use/Expanded Access Programs and CAPRISTANA Registry

Malik

Lorenzo

Pichler

et al. 2020

Cancers

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We examined factors that may impact cabazitaxel treatment duration in a real-life setting in a compassionate use program, expanded access program, and prospective observational study in metastatic castration-resistant prostate cancer (mCRPC). Patients with mCRPC previously treated with docetaxel (N = 1621) received cabazitaxel 25 mg/m2 intravenously every 3 weeks until disease progression, death, unacceptable toxicity or physician/patient decision. The median number of cabazitaxel cycles was six (range, 1–49); 708 patients (43.7%) received >6 cycles. Patients receiving >6 cycles tended to have a better Eastern Cooperative Oncology Group performance status of 0–1 (p = 0.0017 for ≤6 vs. >6 cycles). Overall, 348 patients (21.5%) were ≥75 years of age; 139 (39.9%) received >6 cycles. The main reason for discontinuation was disease progression; however, in patients receiving 1–2 cycles, the main reason for discontinuation was adverse events. Only 52 patients (3.2%) progressed during cycles 1–2. Cabazitaxel was well tolerated in these studies, which included some elderly and frail patients, offering clinicians an important treatment option in the management of mCRPC. Proactive management of adverse events may allow patients to receive a higher number of cabazitaxel cycles and derive greater benefit.

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Section: Discussionmentioning

confidence: 99%

Effect of Baseline Characteristics on Cabazitaxel Treatment Duration in Patients with Metastatic Castration-Resistant Prostate Cancer: A Post Hoc Analysis of the Compassionate Use/Expanded Access Programs and CAPRISTANA Registry

Malik

Lorenzo

Pichler

et al. 2020

Cancers

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“…Then, IHC is further employed in order to identify the primary site. The most commonly added proteins to the IHC CUP staining panel are the keratin family members; CK7 and CK20, with the CK7 + /CK20being the most common in CUP (CK7 + /CK20 -Breast, Ovarian, Pulmonary, Endometrial, Thyroid; CK7 + /CK20 + Upper gastrointestinal, Pancreatic, Urothelial; CK7 -/CK20 + Colorectal, Merkel cell; CK7 -/CK20 -Prostatic, Hepatocellular, Renal cell, and Adrenal cortical) [23]. Other cytoplasmic markers that are commonly added to the IHC staining panels also include; SCGB2A2 and GCDFP-15; breast origin, TTF-1; lung origin, HepPar-1; liver origin, RCC and PSA; renal and prostate origin respectively [24].…”

Section: Immunohistochemistrymentioning

confidence: 99%

Cancer of Unknown Primary Site: Real Entity or Misdiagnosed Disease?

et al. 2020

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Metastasis is a late event in the progression of any tumour. However, invasive cancers are occasionally detected in the form of metastatic lesions without a clearly detectable primary tumour. Cancer of unknown primary site (CUP) is defined as a confirmed metastatic tumour, with unknown primary tumour site, despite the standardized diagnostic approach that includes clinical history, routine laboratory tests, and complete physical examination. Due to the lack of basic research on its primary causes, CUP is appropriately termed an 'orphan' cancer. Nevertheless, CUP accounts for 2-5% of diagnosed malignancies. To date, it is unclear whether CUP is an entity with primary dormancy as its hallmark or an entity with genetic abnormalities that cause it to manifest as a primary metastatic disease. In this review, we discuss different aspects of CUP, including its current diagnostic methods, angiogenesis effectors, relationship with cancer stem cells and current treatments.

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“…CUP is a kind of advanced cancer in which the primary site cannot be determined after the standard diagnostic procedure. It is diagnosed by histological examination primarily, and the patients are preliminarily classified as well or moderately differentiated adenocarcinomas (60%), squamous‐cell carcinomas (5%), carcinomas with neuroendocrine differentiation (1%), poorly differentiated carcinomas (25%–30%), and undifferentiated neoplasm (5%) according to the findings of the first biopsy . Because the location of the primary focus is unclear, site‐specific first‐line therapy cannot be applied; thus, currently, for the treatment of CUP, broad‐spectrum chemotherapy drugs, such as paclitaxel or gemcitabine combined with platinum, are usually used.…”

Section: Introductionmentioning

confidence: 99%

Carcinoma of Unknown Primary withEML4-ALKFusion Response toALKInhibitors

Zhao

Peng

et al. 2019

The Oncologist

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With the advent of next-generation sequencing (NGS) and precision medicine, investigators have determined that tumors from different tissue sources that have the same types of genetic mutations will have a positive response to the same targeted therapy. This finding has prompted us to seek potential therapeutic targets for patients with carcinoma of unknown primary (CUP) using NGS technology. Here, we reported a case of a woman with CUP resistance to chemotherapy. We detected 450 cancer-related gene alterations using three metastatic tumor specimens and found the presence of EML4 exon13 and ALK exon20 fusion. The tumor did respond to crizotinib, a first-generation ALK inhibitor. When her tumor progressed, circulating tumor DNA detection revealed ALK L1196 M and G1269A mutation resistance to crizotinib, but she had a response to brigatinib. This case revealed that NGS technology used to detect the genetic alterations in patients with CUP might be a reliable method to find potential therapeutic targets, although the primary lesion could not always be confirmed. The Oncologist 2019;24:449-454 KEY POINTS• This case exemplifies responsiveness to ALK inhibitor in carcinoma of unknown primary (CUP) with EML4-ALK fusion.• Next-generation sequencing is an important diagnostic tool to find potential therapeutic targets in CUP.• Liquid biopsy may be useful to provide critical information about resistance mechanisms in CUP to guide sequential treatment decision with targeted therapy.

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SEOM clinical guideline on unknown primary cancer (2017)

Cited by 62 publications

References 29 publications

Effect of Baseline Characteristics on Cabazitaxel Treatment Duration in Patients with Metastatic Castration-Resistant Prostate Cancer: A Post Hoc Analysis of the Compassionate Use/Expanded Access Programs and CAPRISTANA Registry

Effect of Baseline Characteristics on Cabazitaxel Treatment Duration in Patients with Metastatic Castration-Resistant Prostate Cancer: A Post Hoc Analysis of the Compassionate Use/Expanded Access Programs and CAPRISTANA Registry

Cancer of Unknown Primary Site: Real Entity or Misdiagnosed Disease?

Carcinoma of Unknown Primary withEML4-ALKFusion Response toALKInhibitors

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