Systematic review of the CUP trials characteristics and perspectives for next-generation studies

Rassy, Elie; Labaki, Chris; Chebel, Roy; Boussios, Stergios; Gagen, Julie Smith; Greco, F. Anthony; Pavlidis, Nicholas

doi:10.1016/j.ctrv.2022.102407

Cited by 14 publications

(12 citation statements)

References 39 publications

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“…The results of these trials could then be compared with those published in historical cases of CUP that received similar treatment at a known primary site. Despite the lack of prospective randomization, similar results will generate rapid progress in this field (28). Positron emission tomography/CT is also valuable for primary tumor diagnosis (29).…”

Section: Discussionmentioning

confidence: 97%

Cancer of unknown primary site in the mandibular region: A case report

Zhong

Chen

et al. 2023

Oncol Lett

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The diagnosis and treatment of cancer of unknown primary site (CUP) present with difficulties and produce a poor prognosis. The current study presents the case of a patient with CUP in the mandibular region was treated with docetaxel and lobaplatin chemotherapy, and vascular embolization of the tumor. The tumor size was markedly reduced and the patient's quality of life improved following radiotherapy. The present case report is accompanied by a discussion of the literature to contextualize the treatment regimen for patients with CUP. These findings will support current treatment practices, inform oncologists and benefit patients with cancer.

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Section: Discussionmentioning

confidence: 97%

Cancer of unknown primary site in the mandibular region: A case report

Zhong

Chen

et al. 2023

Oncol Lett

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“…The assessment of recently published CUP literature allows to recommend two comprehensive clinical trial designs, a visionary and a pragmatic approach. Both are amenable to implementing the latest diagnostics and therapeutic advances to improve the quality of CUP research and the prognosis of many patients [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical features of cancer with unknown primary site (clinical features, treatment, prognosis of cancer with unknown primary site)

Yang

Wen

et al. 2022

BMC Cancer

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Cancer of unknown primary site(CUPs) is a metastatic syndrome with an unidentifiable primary tumor, even after extensive workup to seek the primary site. CUPs accounts for about 3%-5% of the total number of all cancer diagnoses worldwide. The current precision medicine era has reclassified patients with CUPs into the favorable and unfavorable prognostic subset. In this study clinical characteristics and treatment of patients of CUPs were retropactively analysed. Thirty-two patients treated from July 2016 to October 2021 were included in the Affiliated Tumor Hospital of Tianjin Medical University(Tianjin, China).Common symptoms were anemia, fever, enlarged lymph nodes, abdominal pain, edema/multiple serous cavity effusion. Patients with good prognostic factors achieved good outcomes with treatment, conversely, patients with poor prognosis were generally treated empirically and had poorer outcomes. After anti-tumor treatment, the total effective rate was 41 percent(41% was the percentage of patients who achievedtumour respons). To the end of follow-up, after anti-tumor treatment, the median Overall Survival(OS) of patients was 5.4 months.

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“…As for treatment, it is paramount to identify patients who fall into one of the defined “favorable” (20% of CUP) or “unfavorable” subset categories ( 7 ). The percentage of unfavorable patients who do not fit into the previously historically defined favorable subsets is substantially smaller than several years ago, and the favorable subset group is becoming larger ( 8 ). Therefore, the diagnosis is very significant.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Successful Immunotherapy Improved the Prognosis of the Unfavorable Subset of Cancer of Unknown Primary

et al. 2022

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BackgroundCancer of unknown primary (CUP) is heterogeneous and has a wide variety of clinical presentations and a poor prognosis in most patients, with a median overall survival of only 6 months. The development of molecular profiling contributes to precision therapy, and targeted drugs and immune checkpoint inhibitors (ICIs) greatly promote individualized treatment.Case presentationHere, we reported a case of an unfavorable subset of CUP who had a long time of survival after the immunotherapy-prominent comprehensive treatment. A 48-year-old man presented with back pain and a cough. A diagnostic work-up showed bone marrow, multiple bones, and lymph node metastasis. Lymph node pathology implies metastatic poorly differentiated cancer. Next-generation sequencing (NGS) showed no special targets, but the tumor proportion score (TPS) of programmed death-ligand 1 (PD-L1) was 80% and the tumor mutation burden (TMB) was 16.7 per million bases. After two cycles of pembrolizumab 200 mg D1 plus nanoparticle albumin-bound (nab)-paclitaxel 200 mg D1&8 (q3w), PET-CT and bone marrow aspiration cytology showed a complete response (CR). Subsequently, pembrolizumab alone was used for three months. The left inguinal lymph nodes showed new metastasis. After two cycles of the combination treatment of pembrolizumab and (nab)-paclitaxel, a partial response (PR) was achieved. After seven months, retroperitoneal lymph nodes showed new metastasis, and the sequential treatment with radiotherapy and pembrolizumab exhibited encouraging efficacy. To date, the patient has survived nearly 40 months with the combination therapy.ConclusionsThe ICI-prominent comprehensive treatment provided clinical benefit for the reported case of CUP. Thus, CUP patients with markers of benefiting from immunotherapy should be actively treated with immunotherapy to improve their prognosis.

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Systematic review of the CUP trials characteristics and perspectives for next-generation studies

Cited by 14 publications

References 39 publications

Cancer of unknown primary site in the mandibular region: A case report

Cancer of unknown primary site in the mandibular region: A case report

Clinical features of cancer with unknown primary site (clinical features, treatment, prognosis of cancer with unknown primary site)

Case Report: Successful Immunotherapy Improved the Prognosis of the Unfavorable Subset of Cancer of Unknown Primary

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