Molecular characterisation and liquid biomarkers in Carcinoma of Unknown Primary (CUP): taking the 'U' out of 'CUP'

Cancers of Unknown Primary (CUP) comprise a heterogeneous clinical entity of confirmed metastatic cancer where the primary site of origin is undetectable. It has a poor prognosis with limited treatment options. CUP is historically under-researched; however, understanding its biology has the potentia...

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Bibliographic Details
Published in:	British journal of cancer 2019-01, Vol.120 (2), p.141-153
Main Authors:	Conway, Alicia-Marie, Mitchell, Claire, Kilgour, Elaine, Brady, Gerard, Dive, Caroline, Cook, Natalie
Format:	Article
Language:	eng
Subjects:	Biological evolution Biomarkers Biomarkers, Tumor - blood Biopsy Carcinogenesis Carcinoma - blood Carcinoma - genetics Gene Expression Regulation, Neoplastic Historical account Humans Medical prognosis Metastases Neoplasms, Unknown Primary - blood Neoplasms, Unknown Primary - genetics Patients Precision Medicine Prognosis Review Tumors
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Summary:	Cancers of Unknown Primary (CUP) comprise a heterogeneous clinical entity of confirmed metastatic cancer where the primary site of origin is undetectable. It has a poor prognosis with limited treatment options. CUP is historically under-researched; however, understanding its biology has the potential to not only improve treatment and survival by implementation of biomarkers for patient management, but also to greatly contribute to our understanding of carcinogenesis and metastasis across all cancer types. Here we review the current advances in CUP research and explore the debated hypotheses underlying its biology. The evolution of molecular profiling and tissue-of-origin classifiers have the potential to transform the diagnosis, classification and therapeutic management of patients with CUP but robust evidence to support widespread use is lacking. Precision medicine has transformed treatment strategy in known tumour types; in CUP, however, there remains a clinical need for a better understanding of molecular characteristics to establish the potential role of novel or existing therapeutics. The emergence of liquid biopsies as a source of predictive and prognostic biomarkers within known tumour types is gaining rapid ground and this review explores the potential utility of liquid biopsies in CUP.
ISSN:	0007-0920 1532-1827