Treatment

of Cancer of Unknown Primary

If following the evaluation to find the primary site of origin it remains unknown or undiscovered, then a cancer of unknown primary’s treatment can be based on the histology of the cancer (e.g., adenocarcinoma, squamous cell or mesenchymal) or biomarkers identified with the liquid biopsy.1

Surgery, radiation, chemotherapy and precision cancer medicines all are used to treat a CUP depending on the location of the cancer. Even when the cancer is unlikely to be cured, treatment may help the patient live longer or improve the patient’s quality of life. The chemotherapy combination of carboplatin and paclitaxel is often used and the response to treatment is modest with an overall survival of only six to eight months.2

Liquid Biopsies Find Distinct Genomic Profiles in Many Patients with Carcinoma of Unknown Primary

New research suggests that a simple blood test to evaluate circulating tumor DNA (ctDNA) can correctly identify distinct genomic profiles with potentially treatable targetable alterations in patients with CUP.3

Liquid Biopsy and Precision Cancer Medicines

A liquid biopsy with ctDNA evaluation can identify a unique genetic profile that can be treated with currently available precision cancer medicines in a majority of patients with CUP.

Precision cancer medicines are designed to target unique genomic alterations in the cancers DNA that are driving that specific with targeted drugs and immunotherapies engineered to directly attack the cancer cells specific abnormalities, leaving normal cells largely unharmed.

In recent years precision cancer medicine has led to improved treatments for melanoma, lung, colon, breast, and other cancer types. Recently the first “tissue agnostic” approval of a precision cancer medicine was given to Keytruda (pembrolizumab) meaning the actual characteristics of the cancer that determine whether Keytruda is indicated, not the physical location of the cancer were sufficient to direct treatment.2

References


1 http://cancerres.aacrjournals.org/content/77/16/4238

2 http://news.cancerconnect.com/fda-grants-first-tissue-agnostic-accelerated-approval-keytruda/

3 Stella, GM; Senetta, R; Cassenti, A; Ronco, M; Cassoni, P (24 January 2012). “Cancers of unknown primary origin: current perspectives and future therapeutic strategies”. Journal of translational medicine. 10: 12.