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Published in: Journal of Cancer Research and Clinical Oncology 8/2011

01-08-2011 | Original Paper

Second-line chemotherapy in patients with primary unknown cancer

Authors: Makiko Ono, Masashi Ando, Kan Yonemori, Harukaze Yamamoto, Taizo Hirata, Chikako Shimizu, Kenji Tamura, Noriyuki Katsumata, Yasuhiro Fujiwara

Published in: Journal of Cancer Research and Clinical Oncology | Issue 8/2011

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Abstract

Purpose

There are few existing reports on the efficacy of second-line chemotherapy in patients with cancer of unknown primary site (CUP). The aim of this study was to identify characteristics of CUP patients linked to a positive response to chemotherapy.

Methods

We retrospectively studied the clinical outcomes of second-line chemotherapy in patients with CUP who had previously been treated with platinum-based first-line chemotherapy.

Results

A total of 27 patients received second-line chemotherapy. Of these patients, 5 (19%) showed an objective response to second-line chemotherapy; 4 of these patients had shown a favorable response to first-line chemotherapy and had a chemotherapy-free interval (CFI) of more than 4.5 months. Among the 8 patients in whom the CFI was more than 4.5 months, 4 (50%) showed an objective response to platinum-based second-line chemotherapy, whereas among the 16 patients with a CFI of less than 4.5 months, only 1 (6%) showed a response to any chemotherapeutic regimen.

Conclusions

The response to second-line chemotherapy in CUP patients who had received platinum-based first-line treatment seemed to be associated with the response to first-line chemotherapy and the CFI. Although it remains unclear whether second-line chemotherapy might contribute to a survival benefit in patients with CUP, patients who show a favorable response to first-line chemotherapy and also a relatively prolonged CFI appear to be likely to benefit from second-line chemotherapy.
Literature
go back to reference Briasoulis E, Kalofonos H, Bafaloukos D, Samantas E, Fountzilas G, Xiros N, Skarlos D, Christodoulou C, Kosmidis P, Pavlidis N (2000) Carboplatin plus paclitaxel in unknown primary carcinoma: a phase II Hellenic cooperative oncology group study. J Clin Oncol 18(17):3101–3107PubMed Briasoulis E, Kalofonos H, Bafaloukos D, Samantas E, Fountzilas G, Xiros N, Skarlos D, Christodoulou C, Kosmidis P, Pavlidis N (2000) Carboplatin plus paclitaxel in unknown primary carcinoma: a phase II Hellenic cooperative oncology group study. J Clin Oncol 18(17):3101–3107PubMed
go back to reference Culine S, Ychou M, Fabbro M, Romieu G, Cupissol D (2001) 5-fluorouracil and leucovorin as second-line chemotherapy in carcinomas of unknown primary site. Anticancer Res 21(2B):1455–1457PubMed Culine S, Ychou M, Fabbro M, Romieu G, Cupissol D (2001) 5-fluorouracil and leucovorin as second-line chemotherapy in carcinomas of unknown primary site. Anticancer Res 21(2B):1455–1457PubMed
go back to reference Hainsworth JD, Burris HA 3rd, Calvert SW, Willcutt NT, Scullin DC Jr, Bramham J, Greco FA (2001) Gemcitabine in the second-line therapy of patients with carcinoma of unknown primary site: a phase II trial of the Minnie Pearl Cancer Research Network. Cancer Invest 19(4):335–339PubMedCrossRef Hainsworth JD, Burris HA 3rd, Calvert SW, Willcutt NT, Scullin DC Jr, Bramham J, Greco FA (2001) Gemcitabine in the second-line therapy of patients with carcinoma of unknown primary site: a phase II trial of the Minnie Pearl Cancer Research Network. Cancer Invest 19(4):335–339PubMedCrossRef
go back to reference Hainsworth JD, Spigel DR, Raefsky EL, Kuzur ME, Yost K, Kommor M, Litchy S, Greco FA (2005) Combination chemotherapy with gemcitabine and irinotecan in patients with previously treated carcinoma of an unknown primary site: a Minnie Pearl Cancer Research Network Phase II trial. Cancer 104(9):1992–1997. doi:10.1002/cncr.21416 PubMedCrossRef Hainsworth JD, Spigel DR, Raefsky EL, Kuzur ME, Yost K, Kommor M, Litchy S, Greco FA (2005) Combination chemotherapy with gemcitabine and irinotecan in patients with previously treated carcinoma of an unknown primary site: a Minnie Pearl Cancer Research Network Phase II trial. Cancer 104(9):1992–1997. doi:10.​1002/​cncr.​21416 PubMedCrossRef
go back to reference Hainsworth JD, Spigel DR, Farley C, Thompson DS, Shipley DL, Greco FA (2007) Phase II trial of bevacizumab and erlotinib in carcinomas of unknown primary site: the Minnie Pearl Cancer Research Network. J Clin Oncol 25(13):1747–1752. doi:10.1200/JCO.2006.09.3047 PubMedCrossRef Hainsworth JD, Spigel DR, Farley C, Thompson DS, Shipley DL, Greco FA (2007) Phase II trial of bevacizumab and erlotinib in carcinomas of unknown primary site: the Minnie Pearl Cancer Research Network. J Clin Oncol 25(13):1747–1752. doi:10.​1200/​JCO.​2006.​09.​3047 PubMedCrossRef
go back to reference Horlings HM, van Laar RK, Kerst JM, Helgason HH, Wesseling J, van der Hoeven JJ, Warmoes MO, Floore A, Witteveen A, Lahti-Domenici J, Glas AM, Van’t Veer LJ, de Jong D (2008) Gene expression profiling to identify the histogenetic origin of metastatic adenocarcinomas of unknown primary. J Clin Oncol 26(27):4435–4441. doi:10.1200/JCO.2007.14.6969 PubMedCrossRef Horlings HM, van Laar RK, Kerst JM, Helgason HH, Wesseling J, van der Hoeven JJ, Warmoes MO, Floore A, Witteveen A, Lahti-Domenici J, Glas AM, Van’t Veer LJ, de Jong D (2008) Gene expression profiling to identify the histogenetic origin of metastatic adenocarcinomas of unknown primary. J Clin Oncol 26(27):4435–4441. doi:10.​1200/​JCO.​2007.​14.​6969 PubMedCrossRef
go back to reference Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, Miyashita K, Nishizaki T, Kobayashi O, Takiyama W, Toh Y, Nagaie T, Takagi S, Yamamura Y, Yanaoka K, Orita H, Takeuchi M (2008) S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol 9(3):215–221. doi:10.1016/S1470-2045(08)70035-4 PubMedCrossRef Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, Miyashita K, Nishizaki T, Kobayashi O, Takiyama W, Toh Y, Nagaie T, Takagi S, Yamamura Y, Yanaoka K, Orita H, Takeuchi M (2008) S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol 9(3):215–221. doi:10.​1016/​S1470-2045(08)70035-4 PubMedCrossRef
go back to reference Markman M, Rothman R, Hakes T, Reichman B, Hoskins W, Rubin S, Jones W, Almadrones L, Lewis JL Jr (1991) Second-line platinum therapy in patients with ovarian cancer previously treated with cisplatin. J Clin Oncol 9(3):389–393PubMed Markman M, Rothman R, Hakes T, Reichman B, Hoskins W, Rubin S, Jones W, Almadrones L, Lewis JL Jr (1991) Second-line platinum therapy in patients with ovarian cancer previously treated with cisplatin. J Clin Oncol 9(3):389–393PubMed
go back to reference Massard C, Voigt JJ, Laplanche A, Culine S, Lortholary A, Bugat R, Theodore C, Priou F, Kaminsky MC, Lesimple T, Pivot X, Coudert B, Douillard JY, Merrouche Y, Fizazi K (2007) Carcinoma of an unknown primary: Are EGF receptor, Her-2/neu, and c-Kit tyrosine kinases potential targets for therapy? Br J Cancer 97(7):857–861. doi:10.1038/sj.bjc.6603942 PubMed Massard C, Voigt JJ, Laplanche A, Culine S, Lortholary A, Bugat R, Theodore C, Priou F, Kaminsky MC, Lesimple T, Pivot X, Coudert B, Douillard JY, Merrouche Y, Fizazi K (2007) Carcinoma of an unknown primary: Are EGF receptor, Her-2/neu, and c-Kit tyrosine kinases potential targets for therapy? Br J Cancer 97(7):857–861. doi:10.​1038/​sj.​bjc.​6603942 PubMed
go back to reference Pavlidis N, Briasoulis E, Hainsworth J, Greco FA (2003) Diagnostic and therapeutic management of cancer of an unknown primary. Eur J Cancer 39(14):1990–2005PubMedCrossRef Pavlidis N, Briasoulis E, Hainsworth J, Greco FA (2003) Diagnostic and therapeutic management of cancer of an unknown primary. Eur J Cancer 39(14):1990–2005PubMedCrossRef
go back to reference Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92(3):205–216PubMedCrossRef Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92(3):205–216PubMedCrossRef
go back to reference Thigpen JT, Vance RB, Khansur T (1993) Second-line chemotherapy for recurrent carcinoma of the ovary. Cancer 71(4 Suppl):1559–1564PubMedCrossRef Thigpen JT, Vance RB, Khansur T (1993) Second-line chemotherapy for recurrent carcinoma of the ovary. Cancer 71(4 Suppl):1559–1564PubMedCrossRef
go back to reference Varadhachary GR, Talantov D, Raber MN, Meng C, Hess KR, Jatkoe T, Lenzi R, Spigel DR, Wang Y, Greco FA, Abbruzzese JL, Hainsworth JD (2008) Molecular profiling of carcinoma of unknown primary and correlation with clinical evaluation. J Clin Oncol 26(27):4442–4448. doi:10.1200/JCO.2007.14.4378 PubMedCrossRef Varadhachary GR, Talantov D, Raber MN, Meng C, Hess KR, Jatkoe T, Lenzi R, Spigel DR, Wang Y, Greco FA, Abbruzzese JL, Hainsworth JD (2008) Molecular profiling of carcinoma of unknown primary and correlation with clinical evaluation. J Clin Oncol 26(27):4442–4448. doi:10.​1200/​JCO.​2007.​14.​4378 PubMedCrossRef
go back to reference Voog E, Merrouche Y, Trillet-Lenoir V, Lasset C, Peaud PY, Rebattu P, Negrier S (2000) Multicentric phase II study of cisplatin and etoposide in patients with metastatic carcinoma of unknown primary. Am J Clin Oncol 23(6):614–616PubMed Voog E, Merrouche Y, Trillet-Lenoir V, Lasset C, Peaud PY, Rebattu P, Negrier S (2000) Multicentric phase II study of cisplatin and etoposide in patients with metastatic carcinoma of unknown primary. Am J Clin Oncol 23(6):614–616PubMed
go back to reference Yonemori K, Ando M, Yunokawa M, Hirata T, Kouno T, Shimizu C, Tamura K, Katsumata N, Hirakawa A, Matsumoto K, Yamanaka Y, Arioka H, Fujiwara Y (2009) Irinotecan plus carboplatin for patients with carcinoma of unknown primary site. Br J Cancer 100(1):50–55. doi:10.1038/sj.bjc.6604829 PubMedCrossRef Yonemori K, Ando M, Yunokawa M, Hirata T, Kouno T, Shimizu C, Tamura K, Katsumata N, Hirakawa A, Matsumoto K, Yamanaka Y, Arioka H, Fujiwara Y (2009) Irinotecan plus carboplatin for patients with carcinoma of unknown primary site. Br J Cancer 100(1):50–55. doi:10.​1038/​sj.​bjc.​6604829 PubMedCrossRef
Metadata
Title
Second-line chemotherapy in patients with primary unknown cancer
Authors
Makiko Ono
Masashi Ando
Kan Yonemori
Harukaze Yamamoto
Taizo Hirata
Chikako Shimizu
Kenji Tamura
Noriyuki Katsumata
Yasuhiro Fujiwara
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
Journal of Cancer Research and Clinical Oncology / Issue 8/2011
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-011-0983-3

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