Cancer of Unknown Primary: Opportunities and Challenges

• Published in: Indian journal of medical and paediatric oncology Vol. 39; no. 2; pp. 219 - 226
• Main Authors: Rajeev, L K, Asati, Vikas, Lokesh, K N, Rudresh, A H, Babu, Suresh, Jacob, Linu Abraham, Lokanatha, D, Babu, Govind, Lakshmaiah, K C
• Format: Journal Article
• Language: English
• Published: A-12, 2nd Floor, Sector 2, Noida-201301 UP, India Thieme Medical and Scientific Publishers Pvt. Ltd 01.04.2018; Wolters Kluwer India Pvt. Ltd; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd
• Subjects: Cancer therapies; Care and treatment; Chemotherapy; Gene expression; Genetic aspects; Kinases; Lymphatic system; Lymphoma; Melanoma; Metastasis; Morphology; Review Article; Tumors; Unknown primary cancer; molecular tumor profiling; Cancer of unknown primary; immunohistochemistry; empirical chemotherapy
• ISSN: 0971-5851; 0975-2129
• DOI: 10.4103/ijmpo.ijmpo_91_17

Abstract Cancer of unknown primary (CUP) is defined as histologically proven metastatic tumors whose primary site cannot be identified during pretreatment evaluation. Among all malignancies, 3%–5% remained as CUP even after the extensive radiological and pathological workup. Immunohistochemistry and molecular gene expression tumor profiling are being utilized to predict the tissue of origin. Unfortunately, the survival of these patients remains poor (6–9 months) except in 20% of patients who belong to a favorable subset (12–36 months). There is a need to understand the basic biology and to identify the molecular pathways which can be targeted with small molecules. This article reviews our current approach as well as treatment evolution occurred in the past three decades.