[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-380467-105":59,"doc-detail-380467-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","can-precision-oncology-benefit-patients-with-cancers-of-unknown-primary","Can Precision Oncology Benefit Patients With Cancers of Unknown Primary?","","Precision oncology aims to integrate molecular data from patients and tumors to improve tumor characterization and deliver the right therapy at the right dose and time. Cancers of unknown primary (CUP) are metastatic cancers lacking an identifiable origin despite extensive workup, viewed either as an artificial category or a distinct clinical entity. Literature review discusses limits of site-of-origin–based treatment, mixed outcomes in trials such as GEFCAPI04, and proposes adaptive master-protocol and practical single-arm designs to address these challenges and enable better patient-centric strategies.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/can-precision-oncology-benefit-patients-with-cancers-of-unknown-primary/380467/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/can-precision-oncology-benefit-patients-with-cancers-of-unknown-primary/380467.png","ImageObject",300,407,{"name":92,"@type":93},"Cart","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-23","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is precision oncology in the context of CUP?","Question",{"text":112,"@type":113},"Precision oncology uses patient and tumor molecular data to characterize cancers more comprehensively and tailor treatment to individual needs, including determining therapies by molecular insights.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why are cancers of unknown primary (CUP) difficult to treat?",{"text":117,"@type":113},"CUP refers to metastatic tumors without an identifiable anatomical origin at diagnosis, even after extensive investigation, which complicates selecting the most appropriate therapy.",{"name":119,"@type":110,"acceptedAnswer":120},"What do the authors say about site-of-origin–based therapy outcomes?",{"text":121,"@type":113},"The review notes that tumor-type–specific or biomarker-guided strategies based on the suggested primary have not shown statistically significant overall survival improvement, citing limitations observed in trials such as GEFCAPI04.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},380467,1791379260,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39},18829141979164,"https://eur-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Can Precision Oncology Benefit Patients With Cancers of Unknown Primary?  \nElie Rassy*, 1,2,, Fabrice Andre1,3  \n1Gustave Roussy, Départements de Médecine Oncologique, F-94805, Villejuif, France 2CESP, INSERM U1018, Université Paris-Saclay, Villejuif, France  \n3Gustave Roussy, INSERM U981, Université Paris-Saclay, Villejuif, France  \n* Corresponding author: Elie Rassy, MD, MSc, MPH, Department of Medical Oncology, Gustave Roussy, University Paris-Saclay, Villejuif, France. Email: [elie.el-rassy@gustaveroussy.fr](elie.el-rassy@gustaveroussy.fr)  \nAfter half a century of advances, cancer research has evolved from a simplistic to a multidimensional approach covering the intricate and dynamic interactions between cancer cell changes that originate within the cells themselves and their surrounding tumor microenvironment.1 The alterations occurring within the cancer cells, whether they are genomic, transcriptomic, or epigenetic, play a significant role in carcinogenesis. The complexities of this process account for a substantial biological heterogeneity both within and between metastases occurring in the same organ site or different organ microenvironments.2 Furthermore, these complexities are further compounded by the interpatient heterogeneity involving host/microbiota interactions and drug distribution.3 The traditional one-size-fits-all approach could not achieve the expected outcomes despite the latest advances in targeted therapies alongside the development of novel therapeutic approaches. The strategic shift toward precision oncology presents an opportunity to integrate the patient’s and tumor’s molecular data to achieve a more comprehensive characterization of the tumor and tailor the therapeutic approach to each patient’s specific needs, ensuring the right treatment, atthe right dose, and at the right time.4,5  \nCancers of unknown primary (CUP) are hard-to-treat cancers where the traditional definition of cancer based on its primary site is not applicable. This entity encloses a diverse group of metastatic tumors without an identifiable anatomical origin at the time of diagnosis, despite extensive investigations.6 Some experts regard CUP as an artificial classification, suggesting that it comprises malignant metastases originated from undetected primary tumors, and advocate for thorough diagnostic assessments to identify the primary tumor and tailor-targeted therapy accordingly. Conversely, other experts view CUP as a distinct clinical condition with unique characteristics, negating the need to identify the primary tumor and instead favor the use of CUP-specific treatments.7 Advancements in molecular and radiological techniques have dropped the proportion of cancer patients who are diagnosed with CUP to 1%-2% compared to 3%-5% in the early 1990s.8 However, this decline may be influenced by oncologists who  \nprefer to consider the patient with an identifiable primary thus allowing him a broader range of innovative therapies. Using this approach, the accuracy of predicting the site-oforigin using (epi)genomic or transcriptomic CUP classifiers and DNA or RNA sequencing ranged between 54% and 98% and around 61% when using deep learning-based algorithms.7,9  \nThe management of CUP patients based on a suggested primary offers 2 therapeutic strategies that may sometimes overlap: tumor type-specific therapy and biomarker-guided therapy. However, when employing this straightforward precision medicine approach, treatments tailored to the site of origin did not show a statistically significant improvement in overall survival.10 The phase III trial GEFCAPI04 used conventional site-specific therapy based on the suggested primary tumor but encountered several challenges.11 One of the main issues was the disproportionate accrual of pancreaticobiliary and advanced squamous cell carcinomas. Moreover, the GEFCAPI 04 trial was presented in 2019, but its design dates back more than a decade ago with site-specific therapy already predetermined ","cbCaibTO5TFYRVX4","https://ap.wps.com/l/cbCaibTO5TFYRVX4","pdf",1703332,"English","# Introduction\n# CUP: Definition, viewpoints, and diagnostic progress\n# Therapeutic strategies and evidence from trials\n# Unresolved issues and proposed trial designs","[{\"question\":\"What is precision oncology in the context of CUP?\",\"answer\":\"Precision oncology uses patient and tumor molecular data to characterize cancers more comprehensively and tailor treatment to individual needs, including determining therapies by molecular insights.\"},{\"question\":\"Why are cancers of unknown primary (CUP) difficult to treat?\",\"answer\":\"CUP refers to metastatic tumors without an identifiable anatomical origin at diagnosis, even after extensive investigation, which complicates selecting the most appropriate therapy.\"},{\"question\":\"What do the authors say about site-of-origin–based therapy outcomes?\",\"answer\":\"The review notes that tumor-type–specific or biomarker-guided strategies based on the suggested primary have not shown statistically significant overall survival improvement, citing limitations observed in trials such as GEFCAPI04.\"}]","Can Precision Oncology Benefit Patients With Cancers of Unknown Primary? | PDF",1790240321]