Tumour biomarkers in Cancer of Unknown Primary
Research type
Research Study
Full title
Tissue immune biomarkers and tumour molecular characterisation of CUP for identification of predictive/prognostic biomarkers and determination of tissue of origin
IRAS ID
242574
Contact name
Alicia-Marie Conway
Contact email
Clinicaltrials.gov Identifier
18_ALCO_01, MCRC biobank application; 15/NW/0018, TARGET REC number
Duration of Study in the UK
3 years, 2 months, 1 days
Research summary
Summary of Research
Cancers of unknown Primary (CUP) are an important but historically under-researched clinical entity. Patients with CUP have metastatic cancer at diagnosis but standard investigations fail to identify a primary site of origin of the tumour. Patients generally have a very poor prognosis and limited treatment options available to them. Treatment options are limited due to the difficulties in determining the origins of the cancer through usual examination of the tumour tissue. Characterising CUP tumours by genetic changes present in tumour tissue can be used to predict the tumour origins, however it is unclear if treating patients based on these predictions improve survival. Existing novel targeted therapies and immunotherapies have dramatically improved the survival in a proportion of patients with known tumour types but the role of these therapies has not been investigated in patients with CUP tumours. It is hoped that examining the genetic characteristics of CUP tumour tissue will reveal the tissue of origin of these tumours but also enable investigation of tissue immune biomarkers or genetic changes that could predict response to existing or new therapies. It is increasingly recognised that patient blood samples can be used to detect tumour-derived genetic material. We propose analysing this genetic material can reveal tumour characteristics that reflect that of tumour biopsy, can be used to predict a tissue of origin and may help to improve therapeutic options for patients with CUP. In this exploratory laboratory study we hope to elucidate tissue of origin and/or responsiveness to certain therapies and therefore help to improve therapeutic options, and in turn survival, for patients with CUP.
Summary of Results
This study intended to use archival tissue from deceased patients with Cancer of Unknown Primary (CUP) to look for changes in tumour tissue that will enable better diagnosis for CUP.
Using a clinical database of patients who were treated at the Christie hospital since 2010, potential patient samples held within the Trust were identified alongside anonymised clinical data.
The tumour tissue samples were examined by a pathologist and for the majority of cases there was no usable tissue for further analysis. For 16 cases there was adequate tissue samples to send off for molecular profiling, of these, results were obtained for 7 samples.
The research highlighted the challenge of using tissue samples for research purpose in patients with CUP. The small number of successful samples identified and processed meant meaningful conclusions could not be drawn from this approach. Further research will evaluate the role of blood based biomarkers rather that tissue to aid diagnosis in CUP.REC name
North West - Greater Manchester East Research Ethics Committee
REC reference
18/NW/0496
Date of REC Opinion
26 Jul 2018
REC opinion
Favourable Opinion