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Cancer of unknown primary (CUP) is a heterogeneous tumor type that has been diagnosed as a metastatic tumor by pathological examination, but the primary tumor cannot be identified through comprehensive clinical examination. The incidence of CUP accounts for approximately 1%–2% of all tumors. CUP progresses rapidly and has a short course. The treatment and prognosis of patients with CUP are closely linked to the primary site. In clinical settings, identifying the primary tumor remains challenging. Scholars have focused on improving the detection rate. Novel technologies, such as gene expression profiling, high-throughput sequencing, epigenetics, and liquid biopsy, have been successively applied to identify the primary tumor of CUP accurately, sensitively and specifically. With the guidance of molecular diagnosis, targeted therapy, immunotherapy, and combination therapy will usher in the era of precision treatment for CUP, which may become a typical example for individualized therapy.

Cancer of unknown primary (CUP) is a heterogeneous tumor type that has been diagnosed as a metastatic tumor by pathological examination, but the primary tumor cannot be identified through comprehensive clinical examination. The incidence of CUP accounts for approximately 1%–2% of all tumors. CUP progresses rapidly and has a short course. The treatment and prognosis of patients with CUP are closely linked to the primary site. In clinical settings, identifying the primary tumor remains challenging. Scholars have focused on improving the detection rate. Novel technologies, such as gene expression profiling, high- throughput sequencing, epigenetics, and liquid biopsy, have been successively applied to identify the primary tumor of CUP accurately, sensitively and specifically. With the guidance of molecular diagnosis, targeted therapy, immunotherapy, and combination therapy will usher in the era of precision treatment for CUP, which may become a typical example for individualized therapy. [ABSTRACT FROM AUTHOR]

Cancer of unknown primary (CUP) is a metastatic syndrome with an unidentifiable primary tumor even after comprehensive clinical and pathological investigations, accounting for approximately 2%-5% of all newly diagnosed cancers. CUP has some common features including aggressiveness, early dissemination and poor prognosis. With the application of novel molecular tests and drugs, the diagnostic value of gene expression assay and genomic tests in characterizing the molecular features has become increasingly prominent, and new treatment options such as molecular-guided targeted therapy and immunotherapy have become available. This article reviewed the clinical trials of CUP reported at 2023 European Society for Medical Oncology (ESMO) Congress.

Cancer of unknown primary (CUP) is a metastatic syndrome with an unidentifiable primary tumor even after comprehensive clinical and pathological investigations, accounting for approximately 2%-5% of all newly diagnosed cancers. CUP has some common features including aggressiveness, early dissemination and poor prognosis. With the application of novel molecular tests and drugs, the diagnostic value of gene expression assay and genomic tests in characterizing the molecular features has become increasingly prominent, and new treatment options such as molecular-guided targeted therapy and immunotherapy have become available. This article reviewed the clinical trials of CUP reported at 2023 European Society for Medical Oncology (ESMO) Congress. [ABSTRACT FROM AUTHOR]

Cancer of unknown primary (CUP) and cancer of multiple primaries (CMP) are two groups of neoplasm with high heterogeneity, low incidence, limited clinical knowledge and evidence. The diagnosis and treatment of patients with CUP and CMP is challenging. With the progress in the radiology, pathology and genetic features of these diseases, the cooperation and development of multi-disciplinary treatment, along with the investigation of targeted and immunology treatment have updated the treatment of these patients. We intended to guide the diagnosis and treatment of patients with CUP and CMP through this guideline, providing standard guidance for the overall management of patients.

Cancer of unknown primary (CUP) and cancer of multiple primaries (CMP) are two groups of neoplasm with high heterogeneity, low incidence, limited clinical knowledge and evidence. The diagnosis and treatment of patients with CUP and CMP is challenging. With the progress in the radiology, pathology and genetic features of these diseases, the cooperation and development of multi-disciplinary treatment, along with the investigation of targeted and immunology treatment have updated the treatment of these patients. We intended to guide the diagnosis and treatment of patients with CUP and CMP through this guideline, providing standard guidance for the overall management of patients. [ABSTRACT FROM AUTHOR]

Objective To assess the diagnostic value of whole body 18F-fludeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT imaging) in cancer of unknown primary (CUP) and provide references for the detecting strategy of patients with unknown primary metastases. Methods The studies concerning diagnostic value of whole body 18F-FDG PET/CT imaging in the search for primary lesions of CUP were retrieved and screened from the published English and Chinese literatures from January 2010 to March 2019. After data extraction and quality evaluation, the calculation of summary receiver operating pooled sensitivity, specificity and 95%CI, and demonstrated the plots based on the calculation. Summary receiver operating characteristic (SROC) and a funnel graph were drawn. Finally, heterogeneity of the included studies was tested and exploration of the source of the heterogeneity was also included if necessary. Results Eighteen studies were finally included. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio and the corresponding 95%CI, for diagnosis of CUP were 0.88 (95%CI: 0.81~0.92), 0.76 (95%CI: 0.65~0.84), 3.61 (95%CI: 2.4~5.4), 0.16 (95%CI: 0.10~0.27), and 22 (95%CI: 11~46), respectively. The area under the SROC curve (AUC) was 0.89 (95%CI: 0.86~0.92). Conclusion 18F-FDG PET/CT shows sound diagnostic efficiency in detection of primary lesion site in patients with CUP, and is worthy of extensive application and promotion in clinical practice. It is worth noting that future studies should clear the definition of CUP.