Background: Cancers of unknown primary (CUPs) are defined as histologically confirmed metastatic tumours whose primary site cannot be identified during standard pretreatment evaluation. No specific regimen can be recommended as standard of care. Taxanes and platinum-based regimens are commonly used in the first-line treatment of CUPs, but there is no specific regimen for after second-line treatment. In general, late line chemotherapy is not recommended, but we experienced a rare case of CUPs with disseminated disease that showed improvement with fifth-line palliative chemotherapy by specialised approaches based on the reconsideration of histologic type of cancer. We report a rare case in which palliation was achieved by late line chemotherapy based on pathological review. Case: The case was a 65 year-old man. Transverse colectomy and peritoneal metastasectomy were performed for CUPs. The chemotherapy was continued for 3 years afterwards, and the fourth treatment was not effective. The pathological reexamination was carried out in examining the 5th line treatment, and the chemotherapy (pazopanib) was started under the diagnosis of epithelioid sarcoma. The tumor did not shrink, but the antipyretic effect on tumor fever was achieved, resulting in palliation of symptoms. Conclusions: In general, late line chemotherapy for CUPs is not recommended, but palliative chemotherapy based on pathologic profile may be effective and relieve symptoms of CUPs.
| Published in | Journal of Cancer Treatment and Research (Volume 8, Issue 4) |
| DOI | 10.11648/j.jctr.20200804.13 |
| Page(s) | 79-81 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Cancers of Unknown Primary, Late Line Palliative Chemotherapy, Specialised Approaches
| [1] | Culine S. Prognostic factors in unknown primary cancer. Semin Oncol 2009; 36: 60-64. |
| [2] | Thomassen I, Verhoeven RH, van Gestel YR, et al. Population-based incidence, treatment and survival of patients with peritoneal metastases of unknown origin. Eur J Cancer 2014; 50: 50-56. |
| [3] | K. Fizazi, F. A. Greco, N. Pavlidis, et al. Cancers of unknown primary site: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015; 26 Suppl 5: v133–138. |
| [4] | Hainsworth JD, Johnson DH, Greco FA. Cisplatin-based combination chemotherapy in the treatment of poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown primary site: results of a 12-year experience. J Clin Oncol 1992; 10: 912-922. |
| [5] | Van der Gaast A, Verweij J, Henzen-Logmans SC, et al. Carcinoma of unknown primary: identification of a treatable subset?Ann Oncol 1990; 1: 119-122. |
| [6] | Kari Hemminki, Jianguang Ji, Jan Sundquist, et al. Familial risks in cancer of unknown primary: tracking the primary sites. J Clin Oncol 2011; 29 (4): 435-40. |
| [7] | Toussaint E, Bahel-Ball E, Vekemans M, et al. Causes of fever in cancer. Support Care Cancer. 2006; 14 (7): 763-9. |
| [8] | Chang JC. Neoplastic fever. A Proposal for diagnosis. Arch Intern Med. 1989; 149: 1728-30. |
| [9] | Japanese Society of Medical Oncology the Practical Guideline for Carcinoma of Unknown Primary, 2nd Edition, Tokyo, 2018; 62-63. |
| [10] | Prigerson HG, Bao Y, Shah MA, et al. Chemotherapy Use, Performance Status, and Quality of Life at the End of Life. JAMA Oncol 2015; 1 (6): 778-84. |
| [11] | Inoue A, Kobayashi K, Usui K, et al. First-line gefitinib for patients with advanced non-small-cell lung cancer harboring epidermal growth factor receptor mutations without indication for chemotherapy. J Clin Oncol 2009; 27 (9): 1394-400. |
| [12] | https://www.nccn.org/professionals/physiciangls/pdf/occult.pdf. |
| [13] | van der Graaf WT, Blay JY, Chawla SP, et al. Pazopanib for metastatic soft-tissue sarcoma (PALETTE): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet 2012; 379 (9829): 1879-86. |
| [14] | Qi WX, Sun YJ, Tang LN, et al. Risk of gastrointestinal perforation in cancer patients treated with vascular endothelial growth factor receptor tyrosine kinase inhibitors: a systematic review and meta-analysis. Crit Rev Oncol Hematol. 2014; 89 (3): 394-403. |
APA Style
Itaru Sato, Naoki Nakaya, Yoko Obara, Natumi Kurosaka, Souichirou Ueno, et al. (2020). Effectiveness of Late Line Palliative Chemotherapy by Specialised Approach to Cancer of Unknown Primary: A Case Report. Journal of Cancer Treatment and Research, 8(4), 79-81. https://doi.org/10.11648/j.jctr.20200804.13
ACS Style
Itaru Sato; Naoki Nakaya; Yoko Obara; Natumi Kurosaka; Souichirou Ueno, et al. Effectiveness of Late Line Palliative Chemotherapy by Specialised Approach to Cancer of Unknown Primary: A Case Report. J. Cancer Treat. Res. 2020, 8(4), 79-81. doi: 10.11648/j.jctr.20200804.13
AMA Style
Itaru Sato, Naoki Nakaya, Yoko Obara, Natumi Kurosaka, Souichirou Ueno, et al. Effectiveness of Late Line Palliative Chemotherapy by Specialised Approach to Cancer of Unknown Primary: A Case Report. J Cancer Treat Res. 2020;8(4):79-81. doi: 10.11648/j.jctr.20200804.13
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.jctr.20200804.13,
author = {Itaru Sato and Naoki Nakaya and Yoko Obara and Natumi Kurosaka and Souichirou Ueno and Hideo Nakajima},
title = {Effectiveness of Late Line Palliative Chemotherapy by Specialised Approach to Cancer of Unknown Primary: A Case Report},
journal = {Journal of Cancer Treatment and Research},
volume = {8},
number = {4},
pages = {79-81},
doi = {10.11648/j.jctr.20200804.13},
url = {https://doi.org/10.11648/j.jctr.20200804.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jctr.20200804.13},
abstract = {Background: Cancers of unknown primary (CUPs) are defined as histologically confirmed metastatic tumours whose primary site cannot be identified during standard pretreatment evaluation. No specific regimen can be recommended as standard of care. Taxanes and platinum-based regimens are commonly used in the first-line treatment of CUPs, but there is no specific regimen for after second-line treatment. In general, late line chemotherapy is not recommended, but we experienced a rare case of CUPs with disseminated disease that showed improvement with fifth-line palliative chemotherapy by specialised approaches based on the reconsideration of histologic type of cancer. We report a rare case in which palliation was achieved by late line chemotherapy based on pathological review. Case: The case was a 65 year-old man. Transverse colectomy and peritoneal metastasectomy were performed for CUPs. The chemotherapy was continued for 3 years afterwards, and the fourth treatment was not effective. The pathological reexamination was carried out in examining the 5th line treatment, and the chemotherapy (pazopanib) was started under the diagnosis of epithelioid sarcoma. The tumor did not shrink, but the antipyretic effect on tumor fever was achieved, resulting in palliation of symptoms. Conclusions: In general, late line chemotherapy for CUPs is not recommended, but palliative chemotherapy based on pathologic profile may be effective and relieve symptoms of CUPs.},
year = {2020}
}
TY - JOUR T1 - Effectiveness of Late Line Palliative Chemotherapy by Specialised Approach to Cancer of Unknown Primary: A Case Report AU - Itaru Sato AU - Naoki Nakaya AU - Yoko Obara AU - Natumi Kurosaka AU - Souichirou Ueno AU - Hideo Nakajima Y1 - 2020/12/11 PY - 2020 N1 - https://doi.org/10.11648/j.jctr.20200804.13 DO - 10.11648/j.jctr.20200804.13 T2 - Journal of Cancer Treatment and Research JF - Journal of Cancer Treatment and Research JO - Journal of Cancer Treatment and Research SP - 79 EP - 81 PB - Science Publishing Group SN - 2376-7790 UR - https://doi.org/10.11648/j.jctr.20200804.13 AB - Background: Cancers of unknown primary (CUPs) are defined as histologically confirmed metastatic tumours whose primary site cannot be identified during standard pretreatment evaluation. No specific regimen can be recommended as standard of care. Taxanes and platinum-based regimens are commonly used in the first-line treatment of CUPs, but there is no specific regimen for after second-line treatment. In general, late line chemotherapy is not recommended, but we experienced a rare case of CUPs with disseminated disease that showed improvement with fifth-line palliative chemotherapy by specialised approaches based on the reconsideration of histologic type of cancer. We report a rare case in which palliation was achieved by late line chemotherapy based on pathological review. Case: The case was a 65 year-old man. Transverse colectomy and peritoneal metastasectomy were performed for CUPs. The chemotherapy was continued for 3 years afterwards, and the fourth treatment was not effective. The pathological reexamination was carried out in examining the 5th line treatment, and the chemotherapy (pazopanib) was started under the diagnosis of epithelioid sarcoma. The tumor did not shrink, but the antipyretic effect on tumor fever was achieved, resulting in palliation of symptoms. Conclusions: In general, late line chemotherapy for CUPs is not recommended, but palliative chemotherapy based on pathologic profile may be effective and relieve symptoms of CUPs. VL - 8 IS - 4 ER -
Information
Email: