Management of cancer from an unknown primary

Expert Opinion on Pharmacotherapy

Volumn 8, Issue 4, 2007, Pages 445-455

  Armstrong, Anne C ^a   Blackhall, Fiona H ^a  

^a CHRISTIE HOSPITAL   (United Kingdom)

Author keywords

Cancer; CUP; Unknown primary

Indexed keywords

ALTRETAMINE; ANTHRACYCLINE; BLEOMYCIN; CARBOPLATIN; CETUXIMAB; CISPLATIN; CYCLOPHOSPHAMIDE; DOCETAXEL; DOXORUBICIN; EPIRUBICIN; ERLOTINIB; ETOPOSIDE; FLUOROURACIL; FOLINIC ACID; GEFITINIB; GEMCITABINE; GRANULOCYTE MACROPHAGE COLONY STIMULATING FACTOR; IRINOTECAN; METHOTREXATE; MITOMYCIN; MITOMYCIN C; PACLITAXEL; PLATINUM COMPLEX; TAXANE DERIVATIVE; TRASTUZUMAB; TUMOR MARKER; UNINDEXED DRUG; VINBLASTINE; VINCRISTINE; VINDESINE;

ABDOMINAL SCINTISCANNING; BONE MARROW SUPPRESSION; BREAST METASTASIS; CANCER THERAPY; CERVICAL LYMPHADENOPATHY; CLINICAL TRIAL; CYTOREDUCTIVE SURGERY; DIAGNOSTIC ACCURACY; DIAGNOSTIC VALUE; DRUG FATALITY; GERM CELL TUMOR; HUMAN; IMMUNOHISTOCHEMISTRY; LIVER METASTASIS; LUNG ADENOCARCINOMA; LYMPH NODE BIOPSY; LYMPH NODE DISSECTION; LYMPH NODE METASTASIS; METASTASIS; MONOTHERAPY; MULTIPLE CYCLE TREATMENT; NEUROENDOCRINE TUMOR; ONCOGENE NEU; OVARY CANCER; PARTIAL MASTECTOMY; PERITONEUM CANCER; POSITRON EMISSION TOMOGRAPHY; PROSTATE CANCER; REVIEW; SCINTIMAMMOGRAPHY; SEPSIS; TESTIS CANCER; THORAX SCINTISCANNING; THYROID CANCER; TREATMENT RESPONSE; UTERINE CERVIX CANCER;

ANTINEOPLASTIC AGENTS; HUMANS; NEOPLASMS, UNKNOWN PRIMARY;

EID: 33947256508     PISSN: 14656566     EISSN: None     Source Type: Journal    
DOI: 10.1517/14656566.8.4.445     Document Type: Review

References (86)

1. LEMBERSKY BC, THOMAS LC: Metastases of unknown primary site. Med. Clin. North Am. (1996) 80(1):153-171.
2. LEVI F, TE VC, ERLER G, RANDIMBISON L, LA VECCHIA C: Epidemiology of unknown primary tumours. Eur. J. Cancer (2002) 38(13):1810-1812.
3. NEUMANN KH, NYSTROM JS: Metastatic cancer of unknown origin: nonsquamous cell type. Semin. Oncol. (1982) 9(4):427-434.
4. BRIASOULIS E, TOLIS C, BERGH J, PAVLIDIS N: ESMO Minimum clinical recommendations for diagnosis, treatment and follow-up of cancers of unknown primary site (CUP). Ann. Oncol. (2005) 16(Suppl. 1):i75-i76.
5. AASSAR OS, FISCHBEIN NJ, CAPUTO GR et al.: Metastatic head and neck cancer: role and usefulness of FDG PET in locating occult primary tumors. Radiology (1999) 210(1):177-181.
6. JUNGEHULSING M, SCHEIDHAUER K, DAMM M et al.: 2[F]-fluoro-2-deoxy-D-glucose positron emission tomography is a sensitive tool for the detection of occult primary cancer (carcinoma of unknown primary syndrome) with head and neck lymph node manifestation. Otolaryngol. Head Neck Surg. (2000) 123(3):294-301.
7. MILLER FR, HUSSEY D, BEERAM M et al.: Positron emission tomography in the management of unknown primary head and neck carcinoma. Arch. Otolaryngol. Head Neck Surg. (2005) 131(7):626-629.
8. RUSTHOVEN KE, KOSHY M, PAULINO AC: The role of fluorodeoxyglucose positron emission tomography in cervical lymph node metastases from an unknown primary tumor. Cancer (2004) 101(11):2641-2649.
9. KOLE AC, NIEWEG OE, PRUIM J et al.: Detection of unknown occult primary tumors using positron emission tomography. Cancer (1998) 82(6):1160-1166.
10. LASSEN U, DAUGAARD G, EIGTVED A, DAMGAARD K, FRIBERG L: 18F-FDG whole body positron emission tomography (PET) in patients with unknown primary tumours (UPT). Eur. J. Cancer (1999) 35(7):1076-1082.
11. RADES D, KUHNEL G, WILDFANG I et al.: Localised disease in cancer of unknown primary (CUP): the value of positron emission tomography (PET) for individual therapeutic management. Ann. Oncol. (2001) 12(11):1605-1609.
12. SCOTT CL, KUDABA I, STEWART JM, HICKS RJ, RISCHIN D: The utility of 2-deoxy-2-[F-18]fluoro-D-glucose positron emission tomography in the investigation of patients with disseminated carcinoma of unknown primary origin. Mol. Imaging Biol. (2005) 7(3):236-243.
13. NANNI C, RUBELLO D, CASTELLUCCI P et al.: Role of 18F-FDG PET-CT imaging for the detection of an unknown primary tumour: preliminary results in 21 patients. Eur. J. Nucl. Med. Mol. Imaging (2005) 32(5):589-592.
14. GUTZEIT A, ANTOCH G, KUHL H et al.: Unknown primary tumors: detection with dual-modality PET/CT-initial experience. Radiology (2005) 234(1):227-234.
15. CURROW DC, FINDLAY M, COX K, HARNETT PR: Elevated germ cell markers in carcinoma of uncertain primary site do not predict response to platinum based chemotherapy. Eur. J. Cancer (1996) 32A(13):2357-2359.
16. PAVLIDIS N, KALEF-EZRA J, BRIASSOULIS E et al.: Evaluation of six tumor markers in patients with carcinoma of unknown primary. Med. Pediatr. Oncol. (1994) 22(3):162-167.
17. GRECO FA, HAINSWORTH JD: Cancer of Unknown Primary Site. DeVita Jr VT et al. (Ed.) Lippincott Williams & Wilkins, Philidelphia, (2005):2213-2236.
18. MOLL R, FRANKE WW, SCHILLER DL, GEIGER B, KREPLER R: The catalog of human cytokeratins: patterns of expression in normal epithelia, tumors and cultured cells. Cell (1982) 31(1):11-24.
19. SILBERSTEIN E, KORETZ M, CAGNANO E, KATCHKO L, ROSENBERG L: Neuroendocrine (Merkel cell) carcinoma in regional lymph nodes without primary site. Isr. Med. Assoc. J. (2003) 5(6):450-451.
20. RUBIN BP, SKARIN AT, PISICK E, RIZK M, SALGIA R: Use of cytokeratins 7 and 20 in determining the origin of metastatic carcinoma of unknown primary, with special emphasis on lung cancer. Eur. J. Cancer Prev (2001) 10(1):77-82.
21. FOX RM, WOODS RL, TATTERSALL MH, MCGOVERN VJ: Undifferentiated carcinoma in young men: the atypical teratoma syndrome. Lancet (1979) 1(8130):1316-1318.
22. HAINSWORTH JD, GRECO FA: Poorly differentiated carcinoma of unknown primary site. Fer MF et al. (Eds) Grune & Stratton, Orlando, FL (1986):189.
23. RICHARDSON RL, SCHOUMACHER RA, FER MF et al.: The unrecognized extragonadal germ cell cancer syndrome. Ann. Intern. Med. (1981) 94(2):181-186.
24. RICHARDSON RL, GRECO FA, WOLFF SEA: Extragonadal germ cell malignancy: value of tumour markers in metastatic carcinoma of young males. Proc. Am. Assoc. Cancer Res. (1979) 20:204.
25. BLOCK EF, MEYER MA: Positron emission tomography in diagnosis of occult adenocarcinoma of the breast. Am. Surg. (1998) 64(9):906-908.
26. HENRY-TILLMAN RS, HARMS SE, WESTBROOK KC, KOROURIAN S, KLIMBERG VS: Role of breast magnetic resonance imaging in determining breast as a source of unknown metastatic lymphadenopathy. Am. J. Surg. (1999) 178(6):496-500.
27. SCHORN C, FISCHER U, LUFTNER-NAGEL S, WESTERHOF JP, GRABBE E: MRI of the breast in patients with metastatic disease of unknown primary. Eur. Radiol. (1999) 9(3):470-473.
28. ASHIKARI R, ROSEN PP, URBAN JA, SENOO T: Breast cancer presenting as an axillary mass. Ann. Surg. (1976) 183(4):415-417.
29. PATEL J, NEMOTO T, ROSNER D, DAO TL, PICKREN JW: Axillary lymph node metastasis from an occult breast cancer. Cancer (1981) 47(12):2923-2927.
30. GRAU C, JOHANSEN LV, JAKOBSEN J et al.: Cervical lymph node metastases from unknown primary tumours. Results from a national survey by the Danish Society for Head and Neck Oncology. Radiother. Oncol. (2000) 55(2):121-129.
31. HAINSWORTH JD, JOHNSON DH, GRECO FA: Poorly differentiated neuroendocrine carcinoma of unknown primary site. A newly recognized clinicopathologic entity. Ann. Intern. Med. (1988) 109(5):364-371.
32. ASSERSOHN L, NORMAN AR, CUNNINGHAM D et al.: A randomised study of protracted venous infusion of 5-fluorouracil (5-FU) with or without bolus mitomycin C (MMC) in patients with carcinoma of unknown primary. Eur. J. Cancer (2003) 39(8):1121-1128.
33. WAGENER DJ, DE MULDER PH, BURGHOUTS JT, CROLES JJ: Phase II trial of cisplatin for adenocarcinoma of unknown primary site. IKZ/IKO Clinical Research Group. Eur. J. Cancer (1991) 27(6):755-757.
34. VAN DER GAAST A, HENZEN-LOGMANS SC, PLANTING AS, STOTER G, VERWEIJ J: Phase II study of oral administration of etoposide for patients with well- and moderately-differentiated adenocarcinomas of unknown primary site. Ann. Oncol. (1993) 4(9):789-790.
35. WOODS RL, FOX RM, TATTERSALL MH, LEVI JA, BRODIE GN: Metastatic adenocarcinomas of unknown primary site: a randomized study of two combination-chemotherapy regimens. N. Engl. J. Med. (1980) 303(2):87-89.
36. MILLIKEN ST, TATTERSALL MH, WOODS RL et al.: Metastatic adenocarcinoma of unknown primary site. A randomized study of two combination chemotherapy regimens. Eur. J. Cancer Clin. Oncol. (1987) 23(11):1645-1648.
37. EAGAN RT, THERNEAU TM, RUBIN J, LONG HJ, SCHUTT AJ: Lack of value for cisplatin added to mitomycin-doxorubicin combination chemotherapy for carcinoma of unknown primary site. A randomized trial. Am. J. Clin. Oncol. (1987) 10(1):82-85.
38. FALKSON CI, COHEN GL: Mitomycin C, epirubicin and cisplatin versus mitomycin C alone as therapy for carcinoma of unknown primary origin. Oncology (1998) 55(2):116-121.
39. CULINE S, FABBRO M, YCHOU M et al.: Alternative bimonthly cycles of doxorubicin, cyclophosphamide, and etoposide, cisplatin with hematopoietic growth factor support in patients with carcinoma of unknown primary site. Cancer (2002) 94(3):840-846.
40. DOWELL JE, GARRETT AM, SHYR Y, JOHNSON DH, HANDE KR: A randomized Phase II trial in patients with carcinoma of an unknown primary site. Cancer (2001) 91(3):592-597.
41. HAINSWORTH JD, ERLAND JB, KALMAN LA, SCHREEDER MT, GRECO FA: Carcinoma of unknown primary site: treatment with 1-hour paclitaxel, carboplatin, and extended-schedule etoposide. J. Clin. Oncol. (1997) 15(6):2385-2393.
42. GRECO FA, ERLAND JB, MORRISSEY LH et al.: Carcinoma of unknown primary site: Phase II trials with docetaxel plus cisplatin or carboplatin. Ann. Oncol. (2000) 11(2):211-215.
43. GRECO FA, BURRIS HA III, LITCHY S et al.: Gemcitabine, carboplatin, and paclitaxel for patients with carcinoma of unknown primary site: a Minnie Pearl Cancer Research Network study. J. Clin. Oncol. (2002) 20(6):1651-1656.
44. GRECO FA, RODRIGUEZ GI, SHAFFER DW et al.: Carcinoma of unknown primary site: sequential treatment with paclitaxel/carboplatin/etoposide and gemcitabine/irinotecan: a Minnie Pearl Cancer Research Network Phase II trial. Oncologist (2004) 9(6):644-652.
45. VAN DE WOUW AJ, JANSEN RL, SPEEL EJ, HILLEN HF: The unknown biology of the unknown primary tumour: a literature review. Ann. Oncol. (2003) 14(2):191-196.
46. SANDBERG AA, MELONI AM, SUIJKERBUIJK RF: Reviews of chromosome studies in urological tumors. III. Cytogenetics and genes in testicular tumors. J. Urol. (1996) 155(5):1531-1556.
47. HAINSWORTH JD, LENNINGTON WJ, GRECO FA: Overexpression of Her-2 in patients with poorly differentiated carcinoma or poorly differentiated adenocarcinoma of unknown primary site. J. Clin. Oncol. (2000) 18(3):632-635.
48. PAVLIDIS N, BRIASSOULIS E, BAI M, FOUNTZILAS G, AGNANTIS N: Overexpression of C-myc, Ras and C-erbB-2 oncoproteins in carcinoma of unknown primary origin. Anti-Cancer Res. (1995) 15(6B):2563-2567.
49. TSAO MS, SAKURADA A, CUTZ JC et al.: Erlotinib in lung cancer - molecular and clinical predictors of outcome. N. Engl. J. Med. (2005) 353(2):133-144.
50. HILLEN HF, HAK LE, JOOSTEN-ACHJANIE SR, ARENDS JW: Microvessel density in unknown primary tumors. Int. J. Cancer (1997) 74(1):81-85.
51. DENNIS JL, VASS JK, WIT EC, KEITH WN, OIEN KA: Identification from public data of molecular markers of adenocarcinoma characteristic of the site of origin. Cancer Res. (2002) 62(21):5999-6005.
52. TOTHILL RW, KOWALCZYK A, RISCHIN D et al.: An expression-based site of origin diagnostic method designed for clinical application to cancer of unknown origin. Cancer Res. (2005) 65(10):4031-4040.
53. SCHAPIRA DV, JARRETT AR: The need to consider survival, outcome, and expense when evaluating and treating patients with unknown primary carcinoma. Arch. Intern. Med. (1995) 155(19):2050-2054.
54. HESS KR, ABBRUZZESE MC, LENZI R, RABER MN, ABBRUZZESE JL: Classification and regression tree analysis of 1000 consecutive patients with unknown primary carcinoma. Clin. Cancer Res. (1999) 5(11):3403-3410.
55. CULLEN MH, BILLINGHAM LJ, WOODROFFE CM et al.: Mitomycin, ifosfamide, and cisplatin in unresectable non-small-cell lung cancer: effects on survival and quality of life. J. Clin. Oncol. (1999) 17(10):3188-3194.
56. ELLIS PA, SMITH IE, HARDY JR et al.: Symptom relief with MVP (mitomycin C, vinblastine and cisplatin) chemotherapy in advanced non-small-cell lung cancer. Br. J. Cancer (1995) 71(2):366-370.
57. BURRIS HA III, MOORE MJ, ANDERSEN J et al.: Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J. Clin. Oncol. (1997) 15(6):2403-2413.
58. CASPER ES, GREEN MR, KELSEN DP et al.: Phase II trial of gemcitabine (2,2′-difluorodeoxycytidine) in patients with adenocarcinoma of the pancreas. Invest. New Drugs (1994) 12(1):29-34.
59. PENTHEROUDAKIS G, PAVLIDIS N: Perspectives for targeted therapies in cancer of unknown primary site. Cancer Treat. Rev. (2006) 32(8):637-644.
60. JOHNSON RO, CASTRO R, ANSFIELD FJ: Response of primary unknown cancers to treatment with 5-fluorouracil (Nsc-19893). Cancer Chemother Rep. (1964) 38:63-64.
61. MOERTEL CG, REITEMEIER RJ, SCHUTT AJ, HAHN RG: Treatment of the patient with adenocarcinoma of unknown origin. Cancer (1972) 30(6):1469-1472.
62. KELSEN D, MARTIN DS, COLOFIORE J, SAWYER R, COIT D: A Phase II trial of biochemical modulation using N-phosphonacetyl-L-aspartate, high-dose methotrexate, high-dose 5-fluorouracil, and leucovorin in patients with adenocarcinoma of unknown primary site. Cancer (1992) 70(7):1988-1992.
63. SHILDT RA, KENNEDY PS, CHEN TT et al.: Management of patients with metastatic adenocarcinoma of unknown origin: a Southwest Oncology Group study. Cancer Treat. Rep. (1983) 67(1):77-79.
64. ANDERSON H, THATCHER N, RANKIN E et al.: VAC (vincristine, adriamycin, cyclophosphamide) chemotherapy for metastatic carcinoma from an unknown primary site. Eur. J. Cancer Clin. Oncol. (1983) 19(1):49-52.
65. FIORE JJ, KELSEN DP, GRALLA RJ et al.: Adenocarcinoma of unknown primary origin: treatment with vindesine and doxorubicin. Cancer Treat. Rep. (1985) 69(6):591-594.
66. GOLDBERG RM, SMITH FP, UENO W, AHLGREN JD, SCHEIN PS: 5-fluorouracil, adriamycin, and mitomycin in the treatment of adenocarcinoma of unknown primary. J. Clin. Oncol. (1986) 4(3):395-399.
67. BECOUARN Y, BRUNET R, BARBE-GASTON C: Fluorouracil, doxorubicin, cisplatin and altretamine in the treatment of metastatic carcinoma of unknown primary. Eur. J. Cancer Clin. Oncol. (1989) 25(5):861-865.
68. AL-IDRISSI HY: Combined 5-fluorouracil, adriamycin and mitomycin C in the management of adenocarcinoma metastasizing to the liver from an unknown primary site. J. Int. Med. Res. (1990) 18(5):425-429.
69. GILL I, GUAGLIANONE P, GRUNBERG SM, SCHOLZ M, MUGGIA FM: High dose intensity of cisplatin and etoposide in adenocarcinoma of unknown primary. Anti-Cancer Res. (1991) 11(3):1231-1235.
70. LENZI R, RABER MN, FROST P. SCHMIDT S, ABBRUZZESE JL: Phase II study of cisplatin, 5-fluorouracil and folinic acid in patients with carcinoma of unknown primary origin. Eur. J. Cancer (1993) 29A(11):1634.
71. RABER MN, FAINTUCH J, ABBRUZZESE JL, SUMRALL C, FROST P: Continuous infusion 5-fluorouracil, etoposide and cis-diamminedichloroplatinum in patients with metastatic carcinoma of unknown primary origin. Ann. Oncol. (1991) 2(7):519-520.
72. KHANSUR T, ALLRED C, LITTLE D, ANAND V: Cisplatin and 5-fluorouracil for metastatic squamous cell carcinoma from unknown primary. Cancer Invest. (1995) 13(3):263-266.
73. WARNER E, GOEL R, CHANG J et al.: A multicentre Phase II study of carboplatin and prolonged oral etoposide in the treatment of cancer of unknown primary site (CUPS). Br. J. Cancer (1998) 77(12):2376-2380.
74. LOFTS FJ, GOGAS H, MANSI JL: Management of adenocarcinoma of unknown primary with a 5-fluorouracil-cisplatin chemotherapy regimen (CFTam). Ann. Oncol. (1999) 10(11):1389-1392.
75. PARNIS FX, OLVER IN, KOTASEK D et al.: Phase II study of epirubicin, cisplatin and continuous infusion 5-fluorouracil (ECF) for carcinoma of unknown primary site. Ann. Oncol. (2000) 11(7):883-884.
76. SAGHATCHIAN M, FIZAZI K, BOREL C et al.: Carcinoma of an unknown primary site: a chemotherapy strategy based on histological differentiation-results of a prospective study. Ann. Oncol. (2001) 12(4):535-540.
77. MACDONALD AG, NICOLSON MC, SAMUEL LM, HUTCHEON AW, AHMED FY: A Phase II study of mitomycin C, cisplatin and continuous infusion 5-fluorouracil (MCF) in the treatment of patients with carcinoma of unknown primary site. Br. J. Cancer (2002) 86(8):1238-1242.
78. VOOG E, MERROUCHE Y. TRILLET-LENOIR V et al.: Multicentric Phase II study of cisplatin and etoposide in patients with metastatic carcinoma of unknown primary. Am. J. Clin. Oncol. (2000) 23(6):614-616.
79. GUARDIOLA E, PIVOT X, TCHICKNAVORIAN X et al.: Combination of cisplatin-doxorubicin-cyclophosphamide in adenocarcinoma of unknown primary site: a Phase II trial. Am. J. Clin. Oncol. (2001) 24(4):372-375.
80. PIGA A, NORTILLI R, CETTO GL et al.: Carboplatin, doxorubicin and etoposide in the treatment of tumours of unknown primary site. Br. J. Cancer (2004) 90(10):1898-1904.
81. BRIASOULIS E, KALOFONOS H, BAFALOUKOS D et al.: Carboplatin plus paclitaxel in unknown primary carcinoma: a Phase II Hellenic Cooperative Oncology Group Study. J. Clin. Oncol. (2000) 18(17):3101-3107.
82. PARK YH, RYOO BY, CHOI SJ, YANG SH, KIM HT: A Phase II study of paclitaxel plus cisplatin chemotherapy in an unfavourable group of patients with cancer of unknown primary site. Jpn J. Clin. Oncol. (2004) 34(11):681-685.
83. EL-RAYES BF, SHIELDS AF, ZALUPSKI M et al.: A Phase II study of carboplatin and paclitaxel in adenocarcinoma of unknown primary. Am. J. Clin. Oncol. (2005) 28(2):152-156.
84. BALANA C, MANZANO JL, MORENO I et al.: A Phase II study of cisplatin, etoposide and gemcitabine in an unfavourable group of patients with carcinoma of unknown primary site. Ann. Oncol. (2003) 14(9):1425-1429.
85. CULINE S, LORTHOLARY A, VOIGT JJ et al.: Cisplatin in combination with either gemcitabine or irinotecan in carcinomas of unknown primary site: results of a randomized Phase II study - trial for the French Study Group on Carcinomas of Unknown Primary (GEFCAPI 01). J. Clin. Oncol. (2003) 21(18):3479-3482.
86. POUESSEL D, CULINE S, BECHT C et al.: Gemcitabine and docetaxel as front-line chemotherapy in patients with carcinoma of an unknown primary site. Cancer (2004) 100(6):1257-l261.