The management of patients with cancer of unknown primary in middle-income countries: an ESO-AROME survey

• Published in: Future oncology (London, England) Vol. 17; no. 2; pp. 151 - 157
• Main Authors: Pavlidis, Nicholas, Todorovic, Vladimir, Rassy, Elie, Khaled, Hussein, Peccatori, Fedro, Eniu, Alex, Aapro, Matti, Gligorov, Joseph
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01.01.2021
• Subjects: cancer of unknown primary; countries of limited resources; diagnostic; emerging countries; therapeutic management; emerging countries; cancer of unknown primary; diagnostic; therapeutic management; countries of limited resources
• ISSN: 1479-6694; 1744-8301
• DOI: 10.2217/fon-2020-0677

To report on the management strategies in patients with cancer of unknown primary (CUP) in middle-income countries. We conceived a survey of 20 items concerning the management of patients with CUP in daily clinical practice. Only participants from lower- and higher-middle-income countries, as per the World Bank Classification, were eligible for this study. The indications for the first-line treatment did not differ between the two economic regions, whereas those for second-line treatment were more prevalent in higher-middle-income countries. The use of targeted therapy based on immunohistochemistry alone was higher in lower-middle-income countries, although the access to CUP classifiers was similar between the two regions. Proper recommendations must ensure that the economic burden is minimized and that other benefits outweigh the limited survival benefit achieved in patients with CUP. Cancer of unknown primary site (CUP) is a rare occurrence in which doctors identify where a cancer has spread but cannot determine where it originated. The rising cost of cancer care, particularly in patients with CUP, poses a significant challenge for low- and middle-income countries. To inform future guidelines, we conceived a survey of 20 items that focused on the diagnostic tests that doctors use for patients with CUP, as well as the treatment options that they could offer. Only participants from lower- and higher-middle-income countries, as per the World Bank Classification, were eligible for this study. Our results show that the indications for the first round of treatment were similar between the two income brackets, whereas those for the second round of treatment were more prevalent in higher-middle-income countries. The use of targeted therapy based on only one diagnostic test was higher in lower-middle-income countries, despite access to certain indicators of CUP being similar between the two regions.