The international CUPISCO study has revealed significant advances in the treatment of cancer of unknown primary with an unfavorable prognosis. This randomized phase II clinical trial has shown that the use of personalized therapy through genomic profiling analysis can improve the survival of patients affected by this type of tumor compared to the standard chemotherapy treatment currently used. The study results suggest that incorporating the patient’s genomic profile in the initial diagnosis could not only improve patient outcomes but also increase their survival.
CUPISCO is the largest study to date on cancer of unknown primary, involving 159 hospitals in 34 countries and evaluating the efficacy of targeted therapy according to the patient’s genomic profile compared to conventional chemotherapy. It has been observed that patients who received molecularly guided therapy had a disease-free survival of six months compared to those treated with standard chemotherapy.
The study, which has been led by the German Cancer Research Center and recently published in the scientific journal The Lancet, has counted on an outstanding participation of IDIBELL and ICO professionals.
Results that could change the treatment of cancer of unknown primary in the future
Tumours of unknown primary form a heterogeneous group of metastatic cancers where the origin of the tumour cannot be identified despite the exploration carried out at the time of the diagnosis. They account for between 2% and 5% of all cancers and most have a poor prognosis with a median survival of less than a year when treated with standard chemotherapy.
To date, not much progress has been made in improving outcomes for these patients, but it has been observed that a third of them have genomic alterations that can be treated with specific therapies. In fact, the CUPISCO study was designed to test whether the use of the patient’s genomic profile at the time of diagnosis could establish a guided treatment strategy and thus improve outcomes compared to standard chemotherapy treatment.
Thus, this discovery represents an important milestone in the treatment of cancer of unknown primary and suggests that the patient’s genomic profile should be part of the initial diagnosis in order to offer more effective treatment options as it could mean a very important advance in this type of tumor. For the medical oncologist specialized in this type of tumor at IDIBELL and ICO, member of the study’s advisory committee and president of the Spanish Research Group on Cancer of Unknown Origin (GECOD), Dr Ferran Losa, “research in this field is moving forward and the results of the CUPISCO study are promising and could change the way how cancer of unknown primary is treated in the future.”
What is genomic profiling?
The genomic profile is the information about all the genes of a person or a specific cell type, as well as the way in which these genes interact with each other and with the environment. It can be obtained in the laboratory from a sample of tissue, blood or other body fluid. Genomic profiling is used to find out why some people have certain diseases and others don’t. Sometimes it is also done to look for mutations or other genetic changes in a tumor DNA. This helps medical teams understand how different types of cancer form and how they react to treatment, allowing them to formulate new ways of diagnosing, treating and preventing cancer. It is also called genomic characterization.
The Bellvitge Biomedical Research Institute (IDIBELL) is a biomedical research centre created in 2004. It is participated by the Bellvitge University Hospital and the Viladecans Hospital of the Catalan Institute of Health, the Catalan Institute of Oncology, the University of Barcelona and the City Council of L’Hospitalet de Llobregat.
IDIBELL is a member of the Campus of International Excellence of the University of Barcelona HUBc and is part of the CERCA institution of the Generalitat de Catalunya. In 2009 it became one of the first five Spanish research centres to be accredited as a health research institute by the Instituto de Salud Carlos III. In addition, it is part of the “HR Excellence in Research” program of the European Union and is a member of EATRIS and REGIC. Since 2018, IDIBELL has been an Accredited Center of the AECC Scientific Foundation (FCAECC).