Cancer of unknown primary

Cancer of unknown primary refers to cancers where the original location of the disease cannot be located.

Australia's First Cancer of Unknown Primary (CUP) Clinic was established at Peter Mac in February 2012. It is the first dedicated clinic in Australia to deal specifically with patients whose primary cannot be located. Previously such patients were spread through the hospital system depending on symptom presentation and estimates of where the primary might be – gastrointestinal, lung, etc. – or treated in general oncology clinics. As a consequence, people with CUP have sometimes felt lost within the medical system. The clinic will specifically see CUP patients and arrange for them to be systematically assessed, treated and referred for any appropriate clinical trials. Wherever possible patients' tumours will be assessed to determine if any personalised therapies could be future treatment options.

Medical oncologist A/Prof. Linda Mileshkin, who has a major interest in CUP, set up the clinic and now runs it with her team. Consults with surgical and radiation oncology specialists are arranged as needed.

The Cancer of Unknown Primary Service is a collaboration with clinical partners, providing coordinated and comprehensive cancer care. 

Partners

Related experts

Clinics

Cancer of Unknown Primary Clinic, every Monday.

Clinical Trials

We also offer a clinical trials program. Our program offers a wide range of advanced research treatments for many of our patients.

Every cancer patient is at the heart of what we do. Dedicated to you, we commit and pursue state-of-the-art research that we link from bench to bedside and beyond.

If you would like to participate or have questions about clinical trials, speak to your specialist.

Find out more about participating in clinical research at Peter Mac.

The following clinical trials are in progress now.

SUPER – Solving Unknown Primary cancER.

This is a prospective cohort study to create a national information resource and improve the understanding of the molecular biology, clinical, quality of life and psychosocial characteristics of patients with cancer of unknown primary (CUP). The study will be running from 2013 to 2017 and will recruit 300 patients from metropolitan and regional sites across Australia. Research seeking access to the samples collected as part of this study will look to determine the frequency of clinically actionable mutations in CUP tumour samples and evaluate the impact of performing molecular diagnostic tests and feedback of results to influence clinical care of CUP patients.

The project will also seek to establish reliable estimates for quality of life and psychosocial needs across the CUP illness trajectory and to identify similarities and differences between CUP and non-CUP patients from baseline to 12-month follow-up. The long-term objectives of this project are to: significantly improve the diagnostic assessment of CUP patients; integrate new treatment approaches based on molecular therapeutics and likely site of origin; and develop tailored supportive care intervention programs for patients with CUP. 

Outcomes of FoundationOne Directed Therapy in Cancer of Unknown Primary

The goal of the current study is to determine whether Foundation Medicine's next generation sequencing assay, called FoundationOne, will provide information that allows physicians to make treatment decisions using targeted therapies in clinical trials or FDA approved therapies, including "off-label" agents, that result in superior OS compared to historical outcomes for standard CUP therapy. The national clinical trials website has more information.

Referrals

For patients

We understand how stressful and difficult cancer can be.

Your Peter Mac team of experts are dedicated and sensitive to your individual health and wellbeing needs – we are here to help.

You will need a referral from your GP or medical practitioner to access this service.

Patients can be referred from within the hospital, from the rest of Victoria and from around Australia. All referrals should be addressed directly to A/Prof. Mileshkin as the specialist running the clinic.

For health professionals

Visit the referrals page for further information.