About this Research Topic
Cancer of unknown primary (CUP) is a class of metastatic malignancies, of which the site of primary origin can not be determined precisely after a complete assessment including patient history, physical examination, imaging, serum markers, and pathological evaluation of tumor samples. It constitutes 3%-5% of all newly diagnosed cancers per year worldwide. Including cancers of uncertain primary origin, the total number increases to 12%-15% of all newly diagnosed malignancies. Recommended treatments involving empirical chemotherapy have shown modest clinical benefit. The prognosis is unfavorable in 80%-85% of CUP cases, with current overall survival of 2.7-11 months after diagnosis and 1-year survival rate at 15%-20%.
Detection of the primary site of CUP patients may optimize treatment planning, yet the diagnosis of CUP is still challenging due to its late presentation, small lesions, and poorly differentiated tumors. The current diagnosis mainly relies on imaging techniques and histopathology. However, despite technological advances in cancer imaging, primary cancer can be too small to be seen on scans or be hidden by secondary tumors growing nearby. In addition, the clinical efficacy of immunohistochemical detection in CUP has not been fully validated. Precision medicine has transformed treatment strategies in several known tumor types; in CUP, however, there remains a clinical need for novel molecular biomarkers to predict the primary sites of CUP patients and facilitate the development of precision cancer treatment. Development of next-generation sequencing (NGS) technology and novel bioinformatics tools has provided a new and efficient perspective for us to understand the molecular mechanisms of carcinogenesis and to further improve diagnosis and classification of CUP.
For this Research Topic, we aim to present the latest advances in diagnosis and therapeutic treatment of CUP. Understanding the biology of CUP will contribute to not only the improvement of treatment and survival by the implementation of biomarkers for patient management but also a better understanding of cancer carcinogenesis and metastasis.
We welcome Original Research, Reviews, Case Report, and Methods articles covering, but not limited to, the following topics:
1. Epidemiology study of CUP
2. Exploration of molecular mechanisms of carcinogenesis for CUP based on large-scale genomic and transcriptomic data
3. Novel approaches for CUP diagnosis and classification, in particular bioinformatics, statistical, and systems approaches
4. Identification and validation of novel biomarkers based on molecular data alone, or in combination with clinical-pathological or imaging data
5. Clinical application of molecular biomarkers in therapeutic efficacy monitoring and prognosis evaluation
Studies consist solely of bioinformatic investigation of publicly available genomic/transcriptomic data without experimental or in situ validation to support conclusions, or those focused on proteomic and metabolomic investigation, are not in the scope of this Research Topic.
Topic Editor Qinghua Xu is the founder and CEO of Canhelp Genomics Company. The other Topic Editors declare no competing interests with regard to the Research Topic subject.
Keywords: Cancer of Unknown Primary (CUP), Immunochemistry (IHC), Gene Expression Profiling (GEP), Comprehensive Genomic Profiling (CGP), Precision Medicine
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.