Cancer of unknown primary origin medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Roukoz A. Karam, M.D.[2]
Overview
There is no treatment for cancer of unknown primary origin; the mainstay of therapy is supportive care. Medical therapy for cancer of unknown primary origin should be adjusted on an individual basis and according to well-defined clinicopathologic subsets.
Medical Therapy
- There is no treatment for cancer of unknown primary origin; the mainstay of therapy is supportive care.[1]
- The treatment for cancer of unknown primary origin will depend on several factors, such as metastatic origin, biopsy findings, patients age, and performance status.
- Medical therapy for cancer of unknown primary origin should be adjusted on an individual basis and according to well-defined clinicopathologic subsets.[1]
- The table below summarizes different types of medical therapy strategies for cancer of unknown primary origin according to the European Society of Medical Oncology:[2]
| Treatment for cancer of unknown primary origin Adapted from the European Society of Medical Oncology[2] | |
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| Sub-type | Proposed treatment |
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Poorly differentiated neuroendocrine carcinomas of an unknown primary |
Platinum + etoposide combination chemotherapy |
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Well-differentiated neuroendocrine tumour of unknown primary |
Somatostatin analogues, streptozocin + 5-fluorouracil, sunitinib, everolimus |
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Peritoneal adenocarcinomatosis of a serous papillary histological type in females |
Optimal surgical debulking followed by platinum–taxane-based chemotherapy |
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Isolated axillary nodal metastases in females |
Axillary nodal dissection, mastectomy or breast irradiation and adjuvant chemohormonotherapy |
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Squamous cell carcinoma involving non-supraclavicular cervical lymph nodes |
Neck dissection and/or irradiation of bilateral neck and head–neck axis. For advanced stages induction chemotherapy with platinum-based combination or chemoradiation |
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CUP with a colorectal immunohistochemistry (CK20+ CDX2+ CK7−) or molecular profile |
Systemic treatment used for colorectal cancer |
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Single metastatic deposit from unknown primary |
Resection and/or radiotherapy ± systemic therapy |
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Men with blastic bone metastases or immunohistochemistry/serum PSA expression |
Androgen deprivation therapy ± radiotherapy |
References
- ↑ 1.0 1.1 Briasoulis E, Tolis C, Bergh J, Pavlidis N (2005). "ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of cancers of unknown primary site (CUP)". Ann. Oncol. 16 Suppl 1: i75–6. doi:10.1093/annonc/mdi804. PMID 15888766.
- ↑ 2.0 2.1 Fizazi K, Greco FA, Pavlidis N, Daugaard G, Oien K, Pentheroudakis G; et al. (2015). "Cancers of unknown primary site: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up". Ann Oncol. 26 Suppl 5: v133–8. doi:10.1093/annonc/mdv305. PMID 26314775.