Six-year experience of Australia&#39;s first dedicated cancer of unknown primary clinic

van Mourik, A; Tonkin-Hill, G; O&#39;Farrell, J; Waller, S; Tan, L; Tothill, RW; Bowtell, D; Fox, S; Fellowes, A; Fedele, C; Schofield, P; Sivakumaran, T; Wong, HL; Mileshkin, L

Six-year experience of Australia's first dedicated cancer of unknown primary clinic

Author(s): van Mourik, A; Tonkin-Hill, G; O'Farrell, J; Waller, S; Tan, L; Tothill, RW; Bowtell, D; Fox, S; Fellowes, A; Fedele, C; Schofield, P; Sivakumaran, T; Wong, HL; Mileshkin, L;
Details: Publication Year 2023-08,Volume 129,Issue #2,Page 301-308
Journal Title: British Journal of Cancer
Publication Type: Research article
Abstract: BACKGROUND: Diagnosis and management of cancers of unknown primary (CUP) remain challenging. This study examines the referral patterns, management and outcomes of patients referred to Australia's first dedicated CUP clinic. METHODS: Retrospective medical record review was conducted for patients seen at the Peter MacCallum Cancer Centre CUP clinic between July 2014 and August 2020. Overall survival (OS) was analysed for patients with a CUP diagnosis where treatment information was available. RESULTS: Of 361 patients referred, fewer than half had completed diagnostic work-up at the time of referral. A diagnosis of CUP was established in 137 (38%), malignancy other than CUP in 177 (49%) and benign pathology in 36 (10%) patients. Genomic testing was successfully completed in 62% of patients with initial provisional CUP and impacted management in 32% by identifying a tissue of origin or actionable genomic alteration. The use of site-specific, targeted therapy or immunotherapy was independently associated with longer OS compared to empirical chemotherapy. CONCLUSION: Our specialised CUP clinic facilitated diagnostic work-up among patients with suspected malignancy and provided access to genomic testing and clinical trials for patients with a CUP diagnosis, all of which are important to improve outcomes in this patient population.
Publisher: Springer Nature
Keywords: Humans; *Neoplasms, Unknown Primary/diagnosis/genetics/therapy; Retrospective Studies; Genomics; Gene Expression Profiling; Australia/epidemiology
Department(s): Medical Oncology; Laboratory Research; Pathology; Health Services Research
PubMed ID: 37225894
Publisher's Version: https://doi.org/10.1038/s41416-023-02254-6
Open Access at Publisher's Site: https://doi.org/10.1038/s41416-023-02254-6
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-10-12 07:16:45

Last Modified: 2023-10-12 07:16:59