Real-world data analysis of patients with cancer of unknown primary

• Published in: Scientific reports Vol. 11; no. 1; pp. 23074 - 11
• Main Authors: Kang, Sora, Jeong, Jae Ho, Yoon, Shinkyo, Yoo, Changhoon, Kim, Kyu-pyo, Cho, Hyungwoo, Ryoo, Baek-Yeol, Jung, Jinhong, Kim, Jeong Eun
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 29.11.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 631/67; 692/4028; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemotherapy; Cytotoxicity; Data Analysis; Data Collection; Female; High-Throughput Nucleotide Sequencing; Humanities and Social Sciences; Humans; Immunotherapy; Kaplan-Meier Estimate; Male; Malignancy; Medical prognosis; Middle Aged; multidisciplinary; Multivariate Analysis; Neoplasm Metastasis; Neoplasms, Unknown Primary - epidemiology; Neoplasms, Unknown Primary - pathology; Neoplasms, Unknown Primary - therapy; Next-generation sequencing; Patients; Prognosis; Progression-Free Survival; Proportional Hazards Models; Regression analysis; Republic of Korea; Retrospective Studies; Science; Science (multidisciplinary); Survival; Survival Rate; Treatment Outcome; Tumors; Young Adult; Republic of Korea
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-02543-1

Cancer of unknown primary (CUP) is a heterogeneous malignancy in which the primary site of the tumor cannot be identified through standard work-up. The survival outcome of CUP is generally poor, and there is no consensus for treatment. Here, we comprehensively analyzed the real-world data of 218 patients with CUP (median age, 62 years [range, 19–91]; male, 62.3%). Next-generation sequencing was conducted in 22 (10%) patients, one of whom showed level 1 genetic alteration. Most (60.3%) patients were treated with empirical cytotoxic chemotherapy, and two patients received targeted therapy based on the NGS results. The median OS was 8.3 months (95% confidence interval [CI] 6.2–11.4), and the median progression-free survival of patients treated with chemotherapy was 4.4 months (95% CI 3.4–5.3). In multivariate Cox regression analysis, Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1 and localized disease were significantly associated with favorable survival outcomes. Collectively, we found that CUP patients had a poor prognosis after standard treatment, and those with localized disease who received local treatment and those with better PS treated with multiple lines of chemotherapy had better survival outcomes. Targeted therapies based on NGS results are expected to improve survival outcomes.