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- Title
Carcinoma of unknown primary: Molecular tumor board‐based therapy.
- Authors
Shreenivas, Aditya V.; Kato, Shumei; Hu, Jingjing; Skefos, Catherine; Sicklick, Jason; Kurzrock, Razelle
- Abstract
An ongoing randomized phase 2/3 study is evaluating the efficacy of matched NGS-based therapies versus standard-of-care, platinum-based chemotherapies in patients newly diagnosed with I unfavorable i CUP (ClinicalTrials.gov identifier NCT03498521).27 FIGHT-202 was a multicenter, open-label, single-arm study of pemigatinib that enrolled patients with cholangiocarcinoma who had disease progression after at least one prior treatment and had documented I FGF/FGFR i gene status (ClinicalTrials.gov identifier NCT02924376). Discussion of immunotherapy The patient's tumor tissue demonstrated low positive PD-L1 expression (CPS = 2) by IHC, prompting the addition of the checkpoint inhibitor (anti-PD-1) pembrolizumab to the FGFR inhibitor (pemigatinib)-based therapy. Real-world data from our earlier studies have shown that I N-of-one i strategies implemented based on the recommendation of a specialized molecular tumor board can lead to improved patient-related outcomes, including in treatment-naive patients with advanced disease.3-6 Invited discussion from surgery There is often a limited role for surgical intervention in the setting of multifocal, metastatic adenocarcinomas of upper gastrointestinal tract or hepatopancreatobiliary origin, which generally have poor prognoses. Continued case presentation and therapeutic strategy Taking into consideration the advanced-stage, aggressive nature and lack of highly effective conventional systemic therapy options for patients who have CUP, with a median survival <1 year,10 it was reasonable to offer this patient treatment with matched therapies.
- Publication
CA: A Cancer Journal for Clinicians, 2022, Vol 72, Issue 6, p510
- ISSN
0007-9235
- Publication type
Article
- DOI
10.3322/caac.21748