Cancer of unknown primary origin medical therapy: Difference between revisions

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==Medical Therapy==
==Medical Therapy==
*There is no treatment for cancer of unknown primary origin; the mainstay of therapy is supportive care.<ref name="pmid15888766">{{cite journal |vauthors=Briasoulis E, Tolis C, Bergh J, Pavlidis N |title=ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of cancers of unknown primary site (CUP) |journal=Ann. Oncol. |volume=16 Suppl 1 |issue= |pages=i75–6 |year=2005 |pmid=15888766 |doi=10.1093/annonc/mdi804 |url=}}</ref>
*There is no [[Therapy|treatment]] for cancer of unknown primary origin; the mainstay of therapy is supportive care.<ref name="pmid15888766">{{cite journal |vauthors=Briasoulis E, Tolis C, Bergh J, Pavlidis N |title=ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of cancers of unknown primary site (CUP) |journal=Ann. Oncol. |volume=16 Suppl 1 |issue= |pages=i75–6 |year=2005 |pmid=15888766 |doi=10.1093/annonc/mdi804 |url=}}</ref>
*The treatment for cancer of unknown primary origin will depend on several factors, such as [[metastatic]] origin, [[biopsy]] findings, [[Age|patients age]], and [[performance status]].
*The treatment for cancer of unknown primary origin will depend on several factors, such as [[metastatic]] origin, [[biopsy]] findings, [[Age|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.<ref name="pmid15888766">{{cite journal |vauthors=Briasoulis E, Tolis C, Bergh J, Pavlidis N |title=ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of cancers of unknown primary site (CUP) |journal=Ann. Oncol. |volume=16 Suppl 1 |issue= |pages=i75–6 |year=2005 |pmid=15888766 |doi=10.1093/annonc/mdi804 |url=}}</ref>
*Medical therapy for cancer of unknown primary origin should be adjusted on an individual basis and according to well-defined [[Clinical|clinicopathologic]] subsets.<ref name="pmid15888766">{{cite journal |vauthors=Briasoulis E, Tolis C, Bergh J, Pavlidis N |title=ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of cancers of unknown primary site (CUP) |journal=Ann. Oncol. |volume=16 Suppl 1 |issue= |pages=i75–6 |year=2005 |pmid=15888766 |doi=10.1093/annonc/mdi804 |url=}}</ref>
*The table below summarizes different types of medical therapy strategies for cancer of unknown primary origin according to the European Society of Medical Oncology:<ref name="pmid26314775">{{cite journal| author=Fizazi K, Greco FA, Pavlidis N, Daugaard G, Oien K, Pentheroudakis G et al.| title=Cancers of unknown primary site: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. | journal=Ann Oncol | year= 2015 | volume= 26 Suppl 5 | issue=  | pages= v133-8 | pmid=26314775 | doi=10.1093/annonc/mdv305 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26314775  }} </ref>
*The table below summarizes different types of medical therapy strategies for cancer of unknown primary origin according to the European Society of Medical Oncology:<ref name="pmid26314775">{{cite journal| author=Fizazi K, Greco FA, Pavlidis N, Daugaard G, Oien K, Pentheroudakis G et al.| title=Cancers of unknown primary site: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. | journal=Ann Oncol | year= 2015 | volume= 26 Suppl 5 | issue=  | pages= v133-8 | pmid=26314775 | doi=10.1093/annonc/mdv305 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26314775  }} </ref>



Latest revision as of 13:18, 21 October 2019

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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]

Sub-type Proposed treatment

Poorly differentiated neuroendocrine carcinomas of an unknown primary

Platinum + etoposide combination chemotherapy

Well-differentiated neuroendocrine tumour of unknown primary

Somatostatin analogues, streptozocin + 5-fluorouracil, sunitinib, everolimus

Peritoneal adenocarcinomatosis of a serous papillary histological type in females

Optimal surgical debulking followed by platinum–taxane-based chemotherapy

Isolated axillary nodal metastases in females

Axillary nodal dissection, mastectomy or breast irradiation and adjuvant chemohormonotherapy

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

CUP with a colorectal immunohistochemistry (CK20+ CDX2+ CK7−) or molecular profile

Systemic treatment used for colorectal cancer

Single metastatic deposit from unknown primary

Resection and/or radiotherapy ± systemic therapy

Men with blastic bone metastases or immunohistochemistry/serum PSA expression

Androgen deprivation therapy ± radiotherapy

References

  1. 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. 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.

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