Circulating Tumor DNA in Carcinoma of Unknown Primary

MyJourneywithCancer

This recent publication showed a very effective and noninvasive way to determine genetic alterations in cancer with unknown primary. In 99.7% of the patients, the authors found that genomics profiling of tumor DNA circulating in plasma revealed driver mutations that are targetable by drugs.
Cancer Res. 2017 Aug 15;77(16):4238-4246. doi: 10.1158/0008-5472.CAN-17-0628. Epub 2017 Jun 22. Utility of Genomic Analysis In Circulating Tumor DNA from Patients with Carcinoma of Unknown Primary. Kato S1, Krishnamurthy N2, Banks KC3, De P4, Williams K4, Williams C4, Leyland-Jones B4, Lippman SM2, Lanman RB3, Kurzrock R2. https://www.ncbi.nlm.nih.gov/pubmed/28642281

MariahJon

New diagnosis of CUPS!

My brother has just been diagnosed with CUPs and is seeing docs at Penn and Sloan Kettering.  The cancer is in his bones, liver and brain and believe there is something in his lung. he's 63, is still working, has lost weight and other than bone pain is exerevising and keeping a good attitude. I don't even know what questions to ask! I need hopeful stories and recommendations for someone willing to fight, whatever it takes to survive.  Really looking for others who have gone through this strange and confusing cancer journey. If anyone has been to Sloan, best docs, clinical studies, anything?

MyJourneywithCancer

MariahJon said:

New diagnosis of CUPS!

My brother has just been diagnosed with CUPs and is seeing docs at Penn and Sloan Kettering.  The cancer is in his bones, liver and brain and believe there is something in his lung. he's 63, is still working, has lost weight and other than bone pain is exerevising and keeping a good attitude. I don't even know what questions to ask! I need hopeful stories and recommendations for someone willing to fight, whatever it takes to survive.  Really looking for others who have gone through this strange and confusing cancer journey. If anyone has been to Sloan, best docs, clinical studies, anything?

Hello MariahJon
It IS a strange and confusing journey, as you said.
Without any direct personal experience, I would say Sloan is a good place to be.
Since organ-specific treatment plans do not make too much sense in CUPS, I would ask for doing a genomic profiling from biopsy samples, if that is not already done. ctDNA is another option, as shown in the paper I mentioned above.
The NCI-MATCH clinical trial covers 18 mutations and their treatments, and Memorial Sloan-Kettering Cancer Center is listed as one of the study centers that are currently recruiting. I would look for eligibility criterion. The details are here: https://clinicaltrials.gov/ct2/show/study/NCT02465060?show_locs=Y#locn.
Best wishes.