2023年ESMO基于分子指导的原发灶不明肿瘤治疗新进展

doi:10.19401/j.cnki.1007-3639.2023.11.003

中国癌症杂志 ›› 2023, Vol. 33 ›› Issue (11): 989-992.doi: 10.19401/j.cnki.1007-3639.2023.11.003

2023年ESMO基于分子指导的原发灶不明肿瘤治疗新进展

张晓伟(), 刘欣, 罗志国()

复旦大学附属肿瘤医院大内科，复旦大学上海医学院肿瘤学系，上海 200032；

收稿日期:2023-11-15 修回日期:2023-11-18 出版日期:2023-11-30 发布日期:2023-12-14
通信作者: 罗志国（ORCID: 0000-0003-0389-2350），博士，主任医师、硕士研究生导师，复旦大学附属肿瘤医院大内科副主任，复旦大学附属肿瘤医院恶性黑色素瘤诊治中心副主任.
作者简介:张晓伟（ORCID: 0000-0002-7054-9061），博士，副主任医师。
罗志国，医学博士，主任医师，硕士研究生导师。现任复旦大学附属肿瘤医院大内科副主任，复旦大学附属肿瘤医院恶性黑色素瘤诊治中心副主任。兼任上海市抗癌协会多原发和不明原发肿瘤专业委员会主任委员，中国抗癌协会多原发和不明原发肿瘤专业委员会候任主任委员，中国抗癌协会恶性间皮瘤专业委员会副主任委员，上海市抗癌协会肉瘤专业委员会副主任委员，上海市抗癌协会黑色素瘤专业委员会副主任委员，上海市抗癌协会脑转移瘤专业委员会副主任委员，中国抗癌协会肉瘤专业委员会黑色素瘤学组副组长，中国抗癌协会肉瘤专业委员会委员，中国临床肿瘤学会肉瘤专家委员会常务委员，中国抗癌协会肿瘤临床化疗专业委员会常务委员，中国临床肿瘤学会恶性黑色素瘤专家委员会常务委员。在国内外期刊上发表学术论文40余篇，参编书籍9部，主持多项上海科委及省部级课题。曾获复旦大学附属肿瘤医院“十佳医生”和中国抗癌协会科技奖二等奖等。

Progress in clinical management of cancer of unknown primary based on molecular testing at 2023 ESMO

ZHANG Xiaowei(), LIU Xin, LUO Zhiguo()

Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China

Received:2023-11-15 Revised:2023-11-18 Published:2023-11-30 Online:2023-12-14

摘要/Abstract

摘要：

原发灶不明肿瘤（cancer of unknown primary，CUP）是一类组织学上确定为转移并经过一系列检查仍未找到原发灶的肿瘤，占所有新发肿瘤的2%~5%。CUP具有侵袭性强、早期转移及预后差等特征。随着新兴基因检测和药物的应用，基因表达谱和基因组检测在揭示肿瘤分子特征中的价值日益凸显，基于分子指导的靶向治疗和免疫治疗等新的治疗选择也应运而生。本文就2023年欧洲肿瘤学会（European Society for Medical Oncology，ESMO）年会上报道的有关CUP的临床试验进行述评。

关键词: 原发灶不明肿瘤, 90基因检测, 组织起源, 器官特异性治疗, 精准医学

Abstract:

Cancer of unknown primary (CUP) is a metastatic syndrome with an unidentifiable primary tumor even after comprehensive clinical and pathological investigations, accounting for approximately 2%-5% of all newly diagnosed cancers. CUP has some common features including aggressiveness, early dissemination and poor prognosis. With the application of novel molecular tests and drugs, the diagnostic value of gene expression assay and genomic tests in characterizing the molecular features has become increasingly prominent, and new treatment options such as molecular-guided targeted therapy and immunotherapy have become available. This article reviewed the clinical trials of CUP reported at 2023 European Society for Medical Oncology (ESMO) Congress.

Key words: Cancer of unknown primary, 90-gene expression assay, Tissue of origin, Site-specific therapy, Precision medicine

中图分类号:

R730.5

张晓伟, 刘欣, 罗志国. 2023年ESMO基于分子指导的原发灶不明肿瘤治疗新进展[J]. 中国癌症杂志, 2023, 33(11): 989-992.

ZHANG Xiaowei, LIU Xin, LUO Zhiguo. Progress in clinical management of cancer of unknown primary based on molecular testing at 2023 ESMO[J]. China Oncology, 2023, 33(11): 989-992.

参考文献 10

[1]	KRÄMER A, BOCHTLER T, PAULI C, et al. Cancer of unknown primary: ESMO clinical practice guideline for diagnosis, treatment and follow-up[J]. Ann Oncol, 2023, 34(3): 228-246. doi: 10.1016/j.annonc.2022.11.013
[2]	RASSY E, PAVLIDIS N. The currently declining incidence of cancer of unknown primary[J]. Cancer Epidemiol, 2019, 61: 139-141. doi: S1877-7821(19)30056-6 pmid: 31254795
[3]	SUN W, WU W, WANG Q F, et al. Clinical validation of a 90-gene expression test for tumor tissue of origin diagnosis: a large-scale multicenter study of 1417 patients[J]. J Transl Med, 2022, 20(1): 114. doi: 10.1186/s12967-022-03318-6 pmid: 35255924
[4]	LUO Z, LIU X, ZHANG X, et al. A randomized phase Ⅲ trial of site-specific therapy guided by the 90-gene expression assay versus empiric chemotherapy in patients with cancer of unknown primary[J]. Ann Oncol, 2023, 34: S712.
[5]	HAINSWORTH J D, RUBIN M S, SPIGEL D R, et al. Molecular gene expression profiling to predict the tissue of origin and direct site-specific therapy in patients with carcinoma of unknown primary site: a prospective trial of the Sarah Cannon Research Institute[J]. J Clin Oncol, 2013, 31(2): 217-223. doi: 10.1200/JCO.2012.43.3755 pmid: 23032625
[6]	MORAN S, MARTÍNEZ-CARDÚS A, SAYOLS S, et al. Epigenetic profiling to classify cancer of unknown primary: a multicentre, retrospective analysis[J]. Lancet Oncol, 2016, 17(10): 1386-1395. doi: S1470-2045(16)30297-2 pmid: 27575023
[7]	HAYASHI H, TAKIGUCHI Y, MINAMI H, et al. Site-specific and targeted therapy based on molecular profiling by next-generation sequencing for cancer of unknown primary site: a nonrandomized phase 2 clinical trial[J]. JAMA Oncol, 2020, 6(12): 1931-1938. doi: 10.1001/jamaoncol.2020.4643 pmid: 33057591
[8]	HAYASHI H, KURATA T, TAKIGUCHI Y, et al. Randomized phase Ⅱ trial comparing site-specific treatment based on gene expression profiling with carboplatin and paclitaxel for patients with cancer of unknown primary site[J]. J Clin Oncol, 2019, 37(7): 570-579.
[9]	FIZAZI K, MAILLARD A, PENEL N, et al. A phase Ⅲ trial of empiric chemotherapy with cisplatin and gemcitabine or systemic treatment tailored by molecular gene expression analysis in patients with carcinomas of an unknown primary (CUP) site (GEFCAPI 04)[J]. Ann Oncol, 2019, 30: v851.
[10]	MILESHKIN L. Primary analysis of efficacy and safety in the CUPISCO trial: a randomised, global study of targeted therapy or cancer immunotherapy guided by comprehensive genomic profiling (CGP) vs platinum-based chemotherapy (CTX) in newly diagnosed, unfavourable cancer of unknown primary (CUP)[J]. Ann Oncol, 2023, 34: S1254-S1255. doi: 10.1016/j.annonc.2023.10.006

2023年ESMO基于分子指导的原发灶不明肿瘤治疗新进展

Progress in clinical management of cancer of unknown primary based on molecular testing at 2023 ESMO

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