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Cancer of unknown primary—Epidemiological trends and relevance of comprehensive genomic profiling

BACKGROUND: Cancer of unknown primary (CUP) is a distinct clinicopathological entity with poor prognosis, frequently resistant to chemotherapy. Comprehensive genomic profiling (CGP) by next‐generation sequencing potentially identifies novel treatment options for CUP patients. The objective of this s...

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Autores principales: Binder, Carmen, Matthes, Katarina Luise, Korol, Dimitri, Rohrmann, Sabine, Moch, Holger
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6144156/
https://www.ncbi.nlm.nih.gov/pubmed/30019510
http://dx.doi.org/10.1002/cam4.1689
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author Binder, Carmen
Matthes, Katarina Luise
Korol, Dimitri
Rohrmann, Sabine
Moch, Holger
author_facet Binder, Carmen
Matthes, Katarina Luise
Korol, Dimitri
Rohrmann, Sabine
Moch, Holger
author_sort Binder, Carmen
collection PubMed
description BACKGROUND: Cancer of unknown primary (CUP) is a distinct clinicopathological entity with poor prognosis, frequently resistant to chemotherapy. Comprehensive genomic profiling (CGP) by next‐generation sequencing potentially identifies novel treatment options for CUP patients. The objective of this study was to determine incidence and survival trends and to discuss the value of CGP in CUP patients. METHODS: Age‐standardized incidence rates (ASR) per 100 000 were calculated for 2935 CUP patients from 1981 to 2014 using cancer registry data of the canton of Zurich, Switzerland. Kaplan–Meier survival curves were estimated for sex, age, and histological groups. Cox proportional hazards regression models were used to estimate adjusted hazard ratios (HR). A literature review was conducted to assess the current use of CGP in CUP patients. RESULTS: ASR of CUP increased from 10.3 to 17.6 between 1981 and 1997 and decreased to 5.8/100 000 in 2014. Mean overall survival remained stable. Mortality was significantly lower for patients with squamous cell carcinoma (HR 0.48 [95% CI, 0.41‐0.57]) and neuroendocrine carcinoma (0.75 [0.63‐0.88]) and higher for unclassified neoplasms (1.25 [1.13‐1.66]) compared to adenocarcinomas. The literature review identified 10 studies using CGP of CUP tissue. Clinically relevant mutations were identified in up to 85% of CUP patients, of which 13%‐64% may benefit from currently available drugs. CONCLUSIONS: CUP incidence decreased probably due to improved diagnostics, but mortality did not improve over the last 34 years. CGP testing may help to identify molecular signatures in CUP patients and enable targeted treatment.
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spelling pubmed-61441562018-09-24 Cancer of unknown primary—Epidemiological trends and relevance of comprehensive genomic profiling Binder, Carmen Matthes, Katarina Luise Korol, Dimitri Rohrmann, Sabine Moch, Holger Cancer Med Cancer Prevention BACKGROUND: Cancer of unknown primary (CUP) is a distinct clinicopathological entity with poor prognosis, frequently resistant to chemotherapy. Comprehensive genomic profiling (CGP) by next‐generation sequencing potentially identifies novel treatment options for CUP patients. The objective of this study was to determine incidence and survival trends and to discuss the value of CGP in CUP patients. METHODS: Age‐standardized incidence rates (ASR) per 100 000 were calculated for 2935 CUP patients from 1981 to 2014 using cancer registry data of the canton of Zurich, Switzerland. Kaplan–Meier survival curves were estimated for sex, age, and histological groups. Cox proportional hazards regression models were used to estimate adjusted hazard ratios (HR). A literature review was conducted to assess the current use of CGP in CUP patients. RESULTS: ASR of CUP increased from 10.3 to 17.6 between 1981 and 1997 and decreased to 5.8/100 000 in 2014. Mean overall survival remained stable. Mortality was significantly lower for patients with squamous cell carcinoma (HR 0.48 [95% CI, 0.41‐0.57]) and neuroendocrine carcinoma (0.75 [0.63‐0.88]) and higher for unclassified neoplasms (1.25 [1.13‐1.66]) compared to adenocarcinomas. The literature review identified 10 studies using CGP of CUP tissue. Clinically relevant mutations were identified in up to 85% of CUP patients, of which 13%‐64% may benefit from currently available drugs. CONCLUSIONS: CUP incidence decreased probably due to improved diagnostics, but mortality did not improve over the last 34 years. CGP testing may help to identify molecular signatures in CUP patients and enable targeted treatment. John Wiley and Sons Inc. 2018-07-17 /pmc/articles/PMC6144156/ /pubmed/30019510 http://dx.doi.org/10.1002/cam4.1689 Text en © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Cancer Prevention
Binder, Carmen
Matthes, Katarina Luise
Korol, Dimitri
Rohrmann, Sabine
Moch, Holger
Cancer of unknown primary—Epidemiological trends and relevance of comprehensive genomic profiling
title Cancer of unknown primary—Epidemiological trends and relevance of comprehensive genomic profiling
title_full Cancer of unknown primary—Epidemiological trends and relevance of comprehensive genomic profiling
title_fullStr Cancer of unknown primary—Epidemiological trends and relevance of comprehensive genomic profiling
title_full_unstemmed Cancer of unknown primary—Epidemiological trends and relevance of comprehensive genomic profiling
title_short Cancer of unknown primary—Epidemiological trends and relevance of comprehensive genomic profiling
title_sort cancer of unknown primary—epidemiological trends and relevance of comprehensive genomic profiling
topic Cancer Prevention
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6144156/
https://www.ncbi.nlm.nih.gov/pubmed/30019510
http://dx.doi.org/10.1002/cam4.1689
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