Abstract
Background
Molecular tumor profiling is a new method of identifying the tissue of origin in patients
with carcinoma of unknown primary (CUP) site. However the value of this information
in improving treatment outcomes is undefined. We evaluated results of site-specific
treatment in a group of patients with CUP in whom molecular profiling predicted a
colorectal site of origin.
Patients and Methods
Tissue of origin predictions by a 92-gene real-time polymerase chain reaction (RT-PCR)
molecular profiling assay (CancerTYPE ID; bioTheranostics, Inc, San Diego, CA) from
March 2008 to August 2009 were reviewed. One hundred twenty-five of 1544 patients
(8%) assayed were predicted to have a colorectal tissue of origin with > 80% probability.
Surveys were sent to the physicians of these 125 patients requesting deidentified
patient information.
Results
Information was provided for 42 of 125 patients (34%). Thirty-two patients received
either first- or second-line therapy with colorectal cancer regimens; the overall
response rate was 50%. Patients who received first-line empirical therapy for CUP
had an overall response rate of 17%. The median survival of patients who received
site-specific therapy for colorectal cancer was 27 months.
Conclusions
Patients predicted to have a colorectal site of origin by molecular tumor profiling
had median survival when treated with site-specific regimens that was similar to survival
in patients with known metastatic colon cancer. The median survival in this group
was substantially better than the historical median survival for patients with CUP
(range 8-11 months) when treated with empirical CUP regimens. Molecular tumor profiling
seems to improve survival by allowing specific therapy in this patient subgroup; prospective
trials are ongoing to confirm these observations.
Keywords
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Article Info
Publication History
Published online: October 17, 2011
Accepted:
August 9,
2011
Received in revised form:
July 20,
2011
Received:
April 13,
2011
Epub: Oct 14, 2011Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
