Treatable subsets in cancer of unknown primary origin

The purpose of this study was to investigate the treatable subsets in cance r of unknown primary origin (CUP), Fifty patients (27 males and 23 females; median age, 53 Sears) with CUP diagnosed between April 1992 and June 1999 were analyzed retrospectively. Of the 50 patients, 39 received chemotherapy : platinum-based in 31, non-platinum-based in 4, and clinical trials of new agents in 4, Of the 39 patients, 13 (33.3%; 95% confidence interval: 19.1- 50.2%) showed objective responses, with 4 complete responders. Patients wit h poorly differentiated carcinomas in whom beta -subunit of human chorionic gonadotropin (P-HCG) was elevated more than 10 mIU/ml and female patients with peritoneal adenocarcinomatosis achieved high response rates (83.3% and 80%, respectively) with platinum-based chemotherapy, as compared with only a 15.3% response rate in the remaining patients. Platinum-based chemothera py provided promising results in patients with poorly differentiated carcin omas and in female patients with peritoneal adenocarcinomatosis. Significan tly elevated serum levels of P-HCG in patients with poorly differentiated c arcinoma might predict a better response to platinum-based chemotherapy, Ho we c er, the investigation of novel chemotherapeutic approaches is warrante d for other groups of patients with CUP.