Nicholas Pavlidis1,2, Vladimir Todorovic3, Elie Rassy4,5, Hussein Khaled6, Fedro Peccatori7,8, Alex Eniu2,9, Matti Aapro8,10, Joseph Gligorov11. 1. University of Ioannina, Niacrhos Avenue, Ioannina, 45 000, Greece. 2. European School of Oncology College, 20121, Milan, Italy. 3. Oncology & Radiotherapy Clinic, Clinical Center of Montenegro, University of Montenegro, 81000, Podgorica, Montenegro. 4. Department of Medical Oncology, Institut Gustave Roussy, 94800, Villejuif, France. 5. Faculty of Medicine, Department of Oncology, Saint Joseph University, 11-5076, Beirut, Lebanon. 6. Medical Oncology Department, National Cancer Institute, Cairo University, 11796, Giza, Egypt. 7. Fertility & Procreation Unit, Gynecologic Oncology Program, European Institute of Oncology IRCCS, 20141, Milan, Italy. 8. European School of Oncology, 20121, Milan, Italy. 9. Hospital Riviera Chablais, 1847, Rennaz, Switzerland. 10. Breast Center, Genolier Cancer Centre, 1272, Genolier, Switzerland. 11. Institut Universitaire de Cancerologie APHP-Sorbonne Université, 75006, Paris, France.
Abstract
Aim: To report on the management strategies in patients with cancer of unknown primary (CUP) in middle-income countries. Methods: We conceived a survey of 20 items concerning the management of patients with CUP in daily clinical practice. Only participants from lower- and higher-middle-income countries, as per the World Bank Classification, were eligible for this study. Results: The indications for the first-line treatment did not differ between the two economic regions, whereas those for second-line treatment were more prevalent in higher-middle-income countries. The use of targeted therapy based on immunohistochemistry alone was higher in lower-middle-income countries, although the access to CUP classifiers was similar between the two regions. Conclusions: Proper recommendations must ensure that the economic burden is minimized and that other benefits outweigh the limited survival benefit achieved in patients with CUP.
Aim: To report on the management strategies in patients with cancer of unknown primary (CUP) in middle-income countries. Methods: We conceived a survey of 20 items concerning the management of patients with CUP in daily clinical practice. Only participants from lower- and higher-middle-income countries, as per the World Bank Classification, were eligible for this study. Results: The indications for the first-line treatment did not differ between the two economic regions, whereas those for second-line treatment were more prevalent in higher-middle-income countries. The use of targeted therapy based on immunohistochemistry alone was higher in lower-middle-income countries, although the access to CUP classifiers was similar between the two regions. Conclusions: Proper recommendations must ensure that the economic burden is minimized and that other benefits outweigh the limited survival benefit achieved in patients with CUP.
Entities:
Keywords:
cancer of unknown primary; countries of limited resources; diagnostic; emerging countries; therapeutic management
Authors: Holger Moch; Alwin Krämer; Chantal Pauli; Tilmann Bochtler; Linda Mileshkin; Giulia Baciarello; Ferran Losa; Jeffrey S Ross; George Pentheroudakis; George Zarkavelis; Suayib Yalcin; Mustafa Özgüroğlu; Andreas Beringer; Jeremy Scarato; Mathis Mueller-Ohldach; Marlene Thomas Journal: Oncologist Date: 2021-03-25