Cancer of Unknown Primary (CUP) is an intriguing clinical phenomenon. Metastases of a tumor are discovered in a patient, but the primary tumor remains unknown even after extensive investigation. CUP, also known as UPT (Unknown Primary Tumor), TUO (Tumor of Unknown Origin) or UPC (Unknown Primary Carcinoma) represents approximately 5% of all cancer diagnosis.
Patients diagnosed with CUP generally have a very poor prognosis with medium survival rates of 6-9 months, and CUP ranks as the fourth most common cause of cancer death. In the majority of CUP patients (70-80%), the primary tumor can never be identified. Such cases are usually treated with general chemotherapeutic agents such as cisplatin.
Unfortunately, CUP patients usually exhibit a relatively high resistance to this conventional chemotherapy and response rates are consequently low. Treatment results could be significantly improved if the primary tumor was known, especially when adequate treatment is available for this type of tumor.
Studies have shown that the prognosis of cancer patients varies substantially depending on their tumor's site of origin. With CupPrint®, Agendia offers a tool that can significantly improve the diagnostic process for CUP patients.
Using a database of 43 different tumor types, the CupPrint® test can be applied to determine the gene expression profile of a CUP specimen and identify the tissue of origin. With this information, therapy and patient management can be better targeted, frequently resulting in major improvements in treatment response levels and overall prognosis.
Hierarchical Clustering of the CupPrint® Classification database. 495 genes (vertical) in 640 individual tumours (horizontal) are shown.The 640 tumours can be classified into 43 different tumor types as shown by the different colours
Publications
Marc Erlander et al., Molecular classification of carcinoma of unknown primary by gene expression profiling from formalin-fixed paraffin-embedded tissues, Journal of Clinical Oncology, vol 22, No 14S (July 15 Supplement), 2004, 9545.
A.J. van de Wouw et al.,The unknown biology of the unknown primary tumour: a literature review, Annals of Oncology, vol 14, no 2, February 2003, 191-196.
A Maiche, Cancer of unknown primary. A retrospective study based on 109 patients, American Journal Clinical Oncology, vol 16, no 1, February 1993, 26-29.
C. S. Hamilton et al., ACUPS (Adenocarcinoma of Unknown Primary Site): A clinical and cost benefit analysis, International Journal of Radiation Oncology Biology Physics, vol 13, no 10, 1987, 1497-1503