Difference between revisions of "Carcinoma of unknown primary"

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'''Use of this site is subject to you reading and agreeing with the terms set forth in the [[HemOnc.org_-_A_Hematology_Oncology_Wiki:General_disclaimer|disclaimer]].'''
 
'''Use of this site is subject to you reading and agreeing with the terms set forth in the [[HemOnc.org_-_A_Hematology_Oncology_Wiki:General_disclaimer|disclaimer]].'''
  
−
Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are [[How_to_contribute|invited to contribute to the site]].
+
Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are [[How_to_contribute|invited to contribute to the site]].
  
 
Unknown primary tumor may also be referred to as carcinoma of unknown primary site, cancer of unknown primary (CUP), occult primary, or unknown primary carcinoma.
 
Unknown primary tumor may also be referred to as carcinoma of unknown primary site, cancer of unknown primary (CUP), occult primary, or unknown primary carcinoma.
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{| class="wikitable" style="float:right; margin-right: 5px;"
 
{| class="wikitable" style="float:right; margin-right: 5px;"
 
|-
 
|-
−
|<div style="background-color: #66FF66; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} regimens on this page</b></font></div>
+
|<div style="background-color: #66FF66; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} regimens on this page</b></font></div>
−
<div style="background-color: #66CCFF; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} variants on this page</b></font></div>
+
<div style="background-color: #66CCFF; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} variants on this page</b></font></div>
 
|}
 
|}
 
{{TOC limit|limit=3}}
 
{{TOC limit|limit=3}}
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|}
 
|}
 
===Regimen {{#subobject:e0f611|Variant=1}}===
 
===Regimen {{#subobject:e0f611|Variant=1}}===
−
Level of Evidence:
+
{| border="1" style="text-align:center;" !align="left"
−
<span  
+
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://jco.ascopubs.org/content/25/13/1747.full Hainsworth et al. 2007]
 +
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
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border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
−
 
+
|-
−
*[[Bevacizumab (Avastin)]] 10 mg/kg IV on days 1 & 15
+
|}
−
**Infusion times for bevacizumab are 90 minutes for the first dose, then if tolerated, 60 minutes for the second dose, and 30 minutes for the third dose and later  
+
====Chemotherapy====
−
*[[Erlotinib (Tarceva)]] 150 mg PO on days 1-28, 1 hour before or 2 hours after meals  
+
*[[Bevacizumab (Avastin)]] 10 mg/kg IV once per day on days 1 & 15
 +
**Infusion time is 90 minutes for the first dose, then if tolerated, 60 minutes for the second dose, and 30 minutes for the third dose and later  
 +
*[[Erlotinib (Tarceva)]] 150 mg PO on days 1 to 28, 1 hour before or 2 hours after meals  
  
 
'''28-day cycles'''
 
'''28-day cycles'''
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# Hainsworth JD, Spigel DR, Farley C, Thompson DS, Shipley DL, Greco FA; Minnie Pearl Cancer Research Network. Phase II trial of bevacizumab and erlotinib in carcinomas of unknown primary site: the Minnie Pearl Cancer Research Network. J Clin Oncol. 2007 May 1;25(13):1747-52. [http://jco.ascopubs.org/content/25/13/1747.full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/17470864 PubMed]
 
# Hainsworth JD, Spigel DR, Farley C, Thompson DS, Shipley DL, Greco FA; Minnie Pearl Cancer Research Network. Phase II trial of bevacizumab and erlotinib in carcinomas of unknown primary site: the Minnie Pearl Cancer Research Network. J Clin Oncol. 2007 May 1;25(13):1747-52. [http://jco.ascopubs.org/content/25/13/1747.full link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/17470864 PubMed]
  
−
==Carboplatin & Docetaxel {{#subobject:44b3f6|Regimen=1}}==
+
==Bleomycin, Cisplatin, Etoposide {{#subobject:cc3566|Regimen=1}}==
 
{| class="wikitable" style="float:right; margin-left: 5px;"
 
{| class="wikitable" style="float:right; margin-left: 5px;"
 
|-
 
|-
 
|[[#toc|back to top]]
 
|[[#toc|back to top]]
 
|}
 
|}
−
===Regimen #1, Pentheroudakis et al. 2008 {{#subobject:88482c|Variant=1}}===
+
===Regimen {{#subobject:953c7d|Variant=1}}===
−
Level of Evidence:
+
{| border="1" style="text-align:center;" !align="left"
−
<span  
+
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://jco.ascopubs.org/content/10/6/912.long Hainsworth et al 1992]
 +
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
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border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
 +
|-
 +
|}
 +
====Chemotherapy====
 +
*[[Bleomycin (Blenoxane)]] 30 units IV once per day on days 1, 8, 15
 +
*[[Cisplatin (Platinol)]] 20 mg/m<sup>2</sup> IV once per day on days 1 to 5
 +
*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 1 to 5
  
−
*[[Carboplatin (Paraplatin)]] AUC 5 IV over 30 minutes on day 1, given second
+
'''21-day cycles'''
−
*[[Docetaxel (Taxotere)]] 75 mg/m2 IV over 30 minutes on day 1, given first
+
 
 +
===References===
 +
# Hainsworth JD, Johnson DH, Greco FA. Cisplatin-based combination chemotherapy in the treatment of poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown primary site: results of a 12-year experience. J Clin Oncol. 1992 Jun;10(6):912-22. [http://jco.ascopubs.org/content/10/6/912.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/1375284 PubMed]
  
−
'''21-day cycles x up to 8 cycles'''
+
==Carboplatin & Docetaxel {{#subobject:44b3f6|Regimen=1}}==
 +
{| class="wikitable" style="float:right; margin-left: 5px;"
 +
|-
 +
|[[#toc|back to top]]
 +
|}
 +
===Regimen #1 {{#subobject:88482c|Variant=1}}===
 +
{| border="1" style="text-align:center;" !align="left"
 +
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://informahealthcare.com/doi/full/10.1080/02841860701843043 Pentheroudakis et al. 2008]
 +
|<span
 +
style="background:#EEEE00;
 +
padding:3px 6px 3px 6px;
 +
border-color:black;
 +
border-width:2px;
 +
border-style:solid;">Phase II</span>
 +
|-
 +
|}
 +
====Chemotherapy====
 +
*[[Carboplatin (Paraplatin)]] AUC 5 IV over 30 minutes once on day 1, '''given second'''
 +
*[[Docetaxel (Taxotere)]] 75 mg/m<sup>2</sup> IV over 30 minutes once on day 1, '''given first'''
  
−
Supportive medications:
+
====Supportive medications====
 
*[[Dexamethasone (Decadron)]] 8 mg PO BID the day before chemotherapy
 
*[[Dexamethasone (Decadron)]] 8 mg PO BID the day before chemotherapy
 
*[[Dexamethasone (Decadron)]] 16 mg IV prior to chemotherapy, on the day of chemotherapy
 
*[[Dexamethasone (Decadron)]] 16 mg IV prior to chemotherapy, on the day of chemotherapy
−
*Ondansetron (Zofran) 8 mg IV prior to chemotherapy
+
*[[Ondansetron (Zofran)]] 8 mg IV prior to chemotherapy
−
*Ranitidine (Zantac) 100 mg IV prior to chemotherapy
+
*[[Ranitidine (Zantac)]] 100 mg IV prior to chemotherapy
−
*Dimethindene maleate 0.1 mg/kg IV prior to chemotherapy
+
*[[Dimethindene maleate (Fenestil)]] 0.1 mg/kg (route unclear) prior to chemotherapy
  
−
===Regimen #2, Greco et al. 2000 {{#subobject:a56594|Variant=1}}===
+
'''21-day cycle for up to 8 cycles'''
−
Level of Evidence:
+
 
−
<span  
+
===Regimen #2 {{#subobject:a56594|Variant=1}}===
 +
{| border="1" style="text-align:center;" !align="left"
 +
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://annonc.oxfordjournals.org/content/11/2/211.long Greco et al. 2000]
 +
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
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border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
 +
|-
 +
|}
 +
====Chemotherapy====
 +
*[[Carboplatin (Paraplatin)]] AUC 6 IV over 20 minutes once on day 1, '''given second'''
 +
*[[Docetaxel (Taxotere)]] 65 mg/m<sup>2</sup> IV over 1 hour once on day 1, '''given first'''
  
−
*[[Carboplatin (Paraplatin)]] AUC 6 IV over 20 minutes on day 1, given second
+
====Supportive medications====
−
*[[Docetaxel (Taxotere)]] 65 mg/m2 IV over 1 hour on day 1, given first
+
*[[Dexamethasone (Decadron)]] 8 mg PO BID the day before, the day of, and day after chemotherapy
 +
*[[Ondansetron (Zofran)]] 32 mg IV or [[Granisetron (Kytril)]] 10 mcg/kg IV 15 minutes prior to chemotherapy
  
−
'''21-day cycles x 4-8 cycles'''
+
'''21-day cycle for 4 to 8 cycles'''
−
 
 
−
Supportive medications:
 
−
*[[Dexamethasone (Decadron)]] 8 mg PO BID the day before, the day of, and day after chemotherapy
 
−
*Ondansetron (Zofran) 32 mg IV or Granisetron (Kytril) 10 mcg/kg IV 15 minutes prior to chemotherapy
 
  
 
===References===
 
===References===
−
# Greco FA, Erland JB, Morrissey LH, Burris HA 3rd, Hermann RC, Steis R, Thompson D, Gray J, Hainsworth JD. Carcinoma of unknown primary site: phase II trials with docetaxel plus cisplatin or carboplatin. Ann Oncol. 2000 Feb;11(2):211-5. [http://annonc.oxfordjournals.org/content/11/2/211.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/10761758 PubMed]
+
# Greco FA, Erland JB, Morrissey LH, Burris HA 3rd, Hermann RC, Steis R, Thompson D, Gray J, Hainsworth JD. Carcinoma of unknown primary site: phase II trials with docetaxel plus cisplatin or carboplatin. Ann Oncol. 2000 Feb;11(2):211 to 5. [http://annonc.oxfordjournals.org/content/11/2/211.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/10761758 PubMed]
 
# Pentheroudakis G, Briasoulis E, Kalofonos HP, Fountzilas G, Economopoulos T, Samelis G, Koutras A, Karina M, Xiros N, Samantas E, Bamias A, Pavlidis N; Hellenic Cooperative Oncology Group. Docetaxel and carboplatin combination chemotherapy as outpatient palliative therapy in carcinoma of unknown primary: a multicentre Hellenic Cooperative Oncology Group phase II study. Acta Oncol. 2008;47(6):1148-55. [http://informahealthcare.com/doi/full/10.1080/02841860701843043 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18607872 PubMed]
 
# Pentheroudakis G, Briasoulis E, Kalofonos HP, Fountzilas G, Economopoulos T, Samelis G, Koutras A, Karina M, Xiros N, Samantas E, Bamias A, Pavlidis N; Hellenic Cooperative Oncology Group. Docetaxel and carboplatin combination chemotherapy as outpatient palliative therapy in carcinoma of unknown primary: a multicentre Hellenic Cooperative Oncology Group phase II study. Acta Oncol. 2008;47(6):1148-55. [http://informahealthcare.com/doi/full/10.1080/02841860701843043 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18607872 PubMed]
  
−
==Carboplatin & Paclitaxel {{#subobject:910bdc|Regimen=1}}==
+
==Carboplatin, Gemcitabine, Paclitaxel {{#subobject:4d259f|Regimen=1}}==
 
{| class="wikitable" style="float:right; margin-left: 5px;"
 
{| class="wikitable" style="float:right; margin-left: 5px;"
 
|-
 
|-
 
|[[#toc|back to top]]
 
|[[#toc|back to top]]
 
|}
 
|}
−
===Regimen {{#subobject:a386ae|Variant=1}}===
+
===Regimen {{#subobject:96f90f|Variant=1}}===
−
Level of Evidence:
+
{| border="1" style="text-align:center;" !align="left"
−
<span  
+
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://jco.ascopubs.org/content/20/6/1651.long Greco et al. 2002]
 +
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
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border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
 +
|-
 +
|}
 +
====Chemotherapy====
 +
*[[Carboplatin (Paraplatin)]] AUC 5 IV over 20 to 30 minutes once on day 1
 +
*[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV once per day on days 1 & 8
 +
*[[Paclitaxel (Taxol)]] 200 mg/m<sup>2</sup> IV over 1 hour once on day 1
  
−
*[[Carboplatin (Paraplatin)]] AUC 6 IV over 30 minutes on day 1, given first
+
====Supportive medications====
−
*[[Paclitaxel (Taxol)]] 200 mg/m2 IV over 3 hours on day 1, given second
+
*[[:Category:Steroids|Corticosteroids]] IV 30 minutes prior to [[Paclitaxel (Taxol)]]
 +
*[[Diphenhydramine (Benadryl)]] 50 mg IV 30 minutes prior to [[Paclitaxel (Taxol)]]
 +
*[[Cimetidine (Tagamet)]] 300 mg IV 30 minutes prior to [[Paclitaxel (Taxol)]]
  
−
'''21-day cycles x 6-8 cycles'''
+
'''21-day cycles'''
−
 
 
−
Supportive medications:
 
−
*[[Methylprednisolone (Solu-Medrol)]] 32 mg PO 24 and 12 hours before paclitaxel, and 10 minutes before carboplatin
 
−
*[[Dexamethasone (Decadron)]] 16 mg IV over 10 minutes prior to chemotherapy
 
−
*Diphenhydramine (Benadryl) 50 mg IV or dimethindene maleate 0.1 mg/kg IV over 10 minutes prior to chemotherapy
 
−
*Ranitidine (Zantac) 100 mg IV over 10 minutes prior to chemotherapy
 
−
*Ondansetron (Zofran) 8 mg IV after the above premedications
 
−
*[[Filgrastim (Neupogen)]] 300 mcg SC suggested on days 5-12
 
  
 
===References===
 
===References===
−
# Briasoulis E, Kalofonos H, Bafaloukos D, Samantas E, Fountzilas G, Xiros N, Skarlos D, Christodoulou C, Kosmidis P, Pavlidis N. Carboplatin plus paclitaxel in unknown primary carcinoma: a phase II Hellenic Cooperative Oncology Group Study. J Clin Oncol. 2000 Sep;18(17):3101-7. [http://jco.ascopubs.org/content/18/17/3101.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/10963638 PubMed]
+
# Greco FA, Burris HA 3rd, Litchy S, Barton JH, Bradof JE, Richards P, Scullin DC Jr, Erland JB, Morrissey LH, Hainsworth JD. Gemcitabine, carboplatin, and paclitaxel for patients with carcinoma of unknown primary site: a Minnie Pearl Cancer Research Network study. J Clin Oncol. 2002 Mar 15;20(6):1651-6. [http://jco.ascopubs.org/content/20/6/1651.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/11896116 PubMed]
  
−
==Carboplatin, Paclitaxel, Gemcitabine {{#subobject:4d259f|Regimen=1}}==
+
==Carboplatin & Paclitaxel {{#subobject:910bdc|Regimen=1}}==
 
{| class="wikitable" style="float:right; margin-left: 5px;"
 
{| class="wikitable" style="float:right; margin-left: 5px;"
 
|-
 
|-
 
|[[#toc|back to top]]
 
|[[#toc|back to top]]
 
|}
 
|}
−
===Regimen {{#subobject:96f90f|Variant=1}}===
+
===Regimen {{#subobject:a386ae|Variant=1}}===
−
Level of Evidence:
+
{| border="1" style="text-align:center;" !align="left"
−
<span  
+
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://jco.ascopubs.org/content/18/17/3101.long Briasoulis et al. 2000]
 +
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
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border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
 +
|-
 +
|}
 +
====Chemotherapy====
 +
*[[Carboplatin (Paraplatin)]] AUC 6 IV over 30 minutes once on day 1, '''given first'''
 +
*[[Paclitaxel (Taxol)]] 200 mg/m<sup>2</sup> IV over 3 hours once on day 1, '''given second'''
  
−
*[[Carboplatin (Paraplatin)]] AUC 5 IV over 20-30 minutes on day 1
+
====Supportive medications====
−
*[[Paclitaxel (Taxol)]] 200 mg/m2 IV over 1 hour on day 1
+
*[[Methylprednisolone (Solumedrol)]] 32 mg PO 24 and 12 hours before paclitaxel, and 10 minutes before carboplatin
−
*[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV on days 1 & 8
+
*[[Dexamethasone (Decadron)]] 16 mg IV over 10 minutes prior to chemotherapy
 +
*[[Diphenhydramine (Benadryl)]] 50 mg IV or dimethindene maleate 0.1 mg/kg IV over 10 minutes prior to chemotherapy
 +
*[[Ranitidine (Zantac)]] 100 mg IV over 10 minutes prior to chemotherapy
 +
*[[Ondansetron (Zofran)]] 8 mg IV after the above premedications
 +
*[[Filgrastim (Neupogen)]] 300 mcg SC once per day suggested on days 5 to 12
  
−
'''21-day cycles'''
+
'''21-day cycle for 6 to 8 cycles'''
−
 
 
−
Supportive medications:
 
−
*Corticosteroids IV 30 minutes prior to paclitaxel
 
−
*Diphenhydramine (Benadryl) 50 mg IV 30 minutes prior to paclitaxel
 
−
*Cimetidine (Tagamet) 300 mg IV 30 minutes prior to paclitaxel
 
  
 
===References===
 
===References===
−
# Greco FA, Burris HA 3rd, Litchy S, Barton JH, Bradof JE, Richards P, Scullin DC Jr, Erland JB, Morrissey LH, Hainsworth JD. Gemcitabine, carboplatin, and paclitaxel for patients with carcinoma of unknown primary site: a Minnie Pearl Cancer Research Network study. J Clin Oncol. 2002 Mar 15;20(6):1651-6. [http://jco.ascopubs.org/content/20/6/1651.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/11896116 PubMed]
+
# Briasoulis E, Kalofonos H, Bafaloukos D, Samantas E, Fountzilas G, Xiros N, Skarlos D, Christodoulou C, Kosmidis P, Pavlidis N. Carboplatin plus paclitaxel in unknown primary carcinoma: a phase II Hellenic Cooperative Oncology Group Study. J Clin Oncol. 2000 Sep;18(17):3101-7. [http://jco.ascopubs.org/content/18/17/3101.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/10963638 PubMed]
  
 
==Cisplatin (Platinol) {{#subobject:21015c|Regimen=1}}==
 
==Cisplatin (Platinol) {{#subobject:21015c|Regimen=1}}==
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|-
 
|-
 
|}
 
|}
−
*[[Cisplatin (Platinol)]] 100 mg/m2 IV once on day 1
+
====Chemotherapy====
 +
*[[Cisplatin (Platinol)]] 100 mg/m<sup>2</sup> IV once on day 1
  
 
'''21-day cycles'''
 
'''21-day cycles'''
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|}
 
|}
 
===Regimen {{#subobject:61bedc|Variant=1}}===
 
===Regimen {{#subobject:61bedc|Variant=1}}===
−
Level of Evidence:
+
{| border="1" style="text-align:center;" !align="left"
−
<span  
+
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://annonc.oxfordjournals.org/content/11/2/211.long Greco et al. 2000]
 +
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
Line 183: Line 247:
 
border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
 +
|-
 +
|}
 +
====Chemotherapy====
 +
*[[Cisplatin (Platinol)]] 75 mg/m<sup>2</sup> IV over 1 hour once on day 1
 +
*[[Docetaxel (Taxotere)]] 75 mg/m<sup>2</sup> IV over 1 hour once on day 1
  
−
*[[Cisplatin (Platinol)]] 75 mg/m2 IV over 1 hour on day 1
+
====Supportive medications====
−
*[[Docetaxel (Taxotere)]] 75 mg/m2 IV over 1 hour on day 1
 
−
 
 
−
'''21-day cycles x up to 8 cycles'''
 
−
 
 
−
Supportive medications:
 
 
*[[Dexamethasone (Decadron)]] 8 mg PO BID the day before, the day of, and day after chemotherapy
 
*[[Dexamethasone (Decadron)]] 8 mg PO BID the day before, the day of, and day after chemotherapy
−
*Suggested: [[Dexamethasone (Decadron)]] 20 mg IV 15 minutes prior to cisplatin
+
*Suggested: [[Dexamethasone (Decadron)]] 20 mg IV 15 minutes prior to [[Cisplatin (Platinol)]]
 
*2 liters of normal saline with chemotherapy
 
*2 liters of normal saline with chemotherapy
−
*Ondansetron (Zofran) 32 mg IV or Granisetron (Kytril) 10 mcg/kg IV 15 minutes prior to cisplatin
+
*[[Ondansetron (Zofran)]] 32 mg IV or [[Granisetron (Kytril)]] 10 mcg/kg IV 15 minutes prior to [[Cisplatin (Platinol)]]
−
*Ondansetron (Zofran) 8 mg PO TID on days 2-6
+
*[[Ondansetron (Zofran)]] 8 mg PO TID on days 2 to 6
−
 
 
−
===References===
 
−
# Greco FA, Erland JB, Morrissey LH, Burris HA 3rd, Hermann RC, Steis R, Thompson D, Gray J, Hainsworth JD. Carcinoma of unknown primary site: phase II trials with docetaxel plus cisplatin or carboplatin. Ann Oncol. 2000 Feb;11(2):211-5. [http://annonc.oxfordjournals.org/content/11/2/211.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/10761758 PubMed]
 
−
 
 
−
==Cisplatin, Etoposide, Bleomycin {{#subobject:cc3566|Regimen=1}}==
 
−
{| class="wikitable" style="float:right; margin-left: 5px;"
 
−
|-
 
−
|[[#toc|back to top]]
 
−
|}
 
−
===Regimen {{#subobject:953c7d|Variant=1}}===
 
−
Level of Evidence:
 
−
<span
 
−
style="background:#EEEE00;
 
−
padding:3px 6px 3px 6px;
 
−
border-color:black;
 
−
border-width:2px;
 
−
border-style:solid;">Non-randomized</span>
 
−
 
 
−
*[[Cisplatin (Platinol)]] 20 mg/m2 IV on days 1-5
 
−
*[[Etoposide (Vepesid)]] 100 mg/m2 IV on days 1-5
 
−
*[[Bleomycin (Blenoxane)]] 30 units IV on days 1, 8, 15
 
  
−
'''21-day cycles'''
+
'''21-day cycle for up to 8 cycles'''
  
 
===References===
 
===References===
−
# Hainsworth JD, Johnson DH, Greco FA. Cisplatin-based combination chemotherapy in the treatment of poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown primary site: results of a 12-year experience. J Clin Oncol. 1992 Jun;10(6):912-22. [http://jco.ascopubs.org/content/10/6/912.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/1375284 PubMed]
+
# Greco FA, Erland JB, Morrissey LH, Burris HA 3rd, Hermann RC, Steis R, Thompson D, Gray J, Hainsworth JD. Carcinoma of unknown primary site: phase II trials with docetaxel plus cisplatin or carboplatin. Ann Oncol. 2000 Feb;11(2):211 to 5. [http://annonc.oxfordjournals.org/content/11/2/211.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/10761758 PubMed]
  
 
==Cisplatin & Gemcitabine {{#subobject:a36533|Regimen=1}}==
 
==Cisplatin & Gemcitabine {{#subobject:a36533|Regimen=1}}==
Line 252: Line 295:
 
|-
 
|-
 
|}
 
|}
−
*[[Cisplatin (Platinol)]] 100 mg/m2 IV once on day 1
+
====Chemotherapy====
−
*[[Gemcitabine (Gemzar)]] 1250 mg/m2 IV once per day on days 1 & 8
+
*[[Cisplatin (Platinol)]] 100 mg/m<sup>2</sup> IV once on day 1
 +
*[[Gemcitabine (Gemzar)]] 1250 mg/m<sup>2</sup> IV once per day on days 1 & 8
  
 
'''21-day cycles'''
 
'''21-day cycles'''
Line 282: Line 326:
 
|-
 
|-
 
|}
 
|}
−
*[[Cisplatin (Platinol)]] 80 mg/m2 IV once on day 1
+
====Chemotherapy====
−
*[[Irinotecan (Camptosar)]] 150 mg/m2 IV once on day 1
+
*[[Cisplatin (Platinol)]] 80 mg/m<sup>2</sup> IV once on day 1
 +
*[[Irinotecan (Camptosar)]] 150 mg/m<sup>2</sup> IV once on day 1
  
 
'''21-day cycles'''
 
'''21-day cycles'''
Line 296: Line 341:
 
|}
 
|}
 
===Regimen {{#subobject:a67a4e|Variant=1}}===
 
===Regimen {{#subobject:a67a4e|Variant=1}}===
−
Level of Evidence:
+
{| border="1" style="text-align:center;" !align="left"
−
<span  
+
|'''Study'''
 +
|[[Levels_of_Evidence#Evidence|'''Evidence''']]
 +
|-
 +
|[http://onlinelibrary.wiley.com/doi/10.1002/cncr.20100/full Pouessel et al. 2004]
 +
|<span  
 
style="background:#EEEE00;
 
style="background:#EEEE00;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
Line 303: Line 352:
 
border-width:2px;
 
border-width:2px;
 
border-style:solid;">Phase II</span>
 
border-style:solid;">Phase II</span>
 +
|-
 +
|}
 +
====Chemotherapy====
 +
*[[Docetaxel (Taxotere)]] 75 mg/m<sup>2</sup> IV over 1 hour once on day 8
 +
*[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1 & 8
  
−
*[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV over 30 minutes on days 1 & 8
+
====Supportive medications====
−
*[[Docetaxel (Taxotere)]] 75 mg/m2 IV over 1 hour on day 8
+
*[[:Category:Steroids|Corticosteroids]] PO the day before, the day of, and day after [[Docetaxel (Taxotere)]]
  
−
'''21-day cycles x up to 6 cycles'''
+
'''21-day cycle for up to 6 cycles'''
−
 
 
−
Supportive medications:
 
−
*Corticosteroids PO the day before, the day of, and day after docetaxel
 
  
 
===References===
 
===References===
Line 336: Line 387:
 
|-
 
|-
 
|}
 
|}
 +
====Chemotherapy====
 +
*[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV once per day on days 1 & 8
 +
*[[Irinotecan (Camptosar)]] 100 mg/m<sup>2</sup> IV once per day on days 1 & 8
  
−
*[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV once per day on days 1 & 8
+
'''21-day cycle for up to 6 cycles'''
−
*[[Irinotecan (Camptosar)]] 100 mg/m2 IV once per day on days 1 & 8
 
−
 
 
−
'''21-day cycle x up to 6 cycles'''
 
  
 
===References===
 
===References===
Line 376: Line 427:
 
|-
 
|-
 
|}
 
|}
−
 
+
====Chemotherapy====
−
*[[Paclitaxel (Taxol)]] 200 mg/m2 IV over 1 hour once on day 1
+
*[[Paclitaxel (Taxol)]] 200 mg/m<sup>2</sup> IV over 1 hour once on day 1
 
*[[Carboplatin (Paraplatin)]] AUC 6 IV over 20 to 30 minutes once on day 1
 
*[[Carboplatin (Paraplatin)]] AUC 6 IV over 20 to 30 minutes once on day 1
 
*[[Etoposide (Vepesid)]] 50 mg PO once per day on days 1, 3, 5, 7, 9, and 100 mg PO once per day on days 2, 4, 6, 8, 10
 
*[[Etoposide (Vepesid)]] 50 mg PO once per day on days 1, 3, 5, 7, 9, and 100 mg PO once per day on days 2, 4, 6, 8, 10
  
−
'''21-day cycles x 4 to 8 cycles'''
+
====Supportive medications====
 +
*[[Dexamethasone (Decadron)]] 20 mg PO 12 hours and 4 hours prior to [[Paclitaxel (Taxol)]]
 +
*[[Dexamethasone (Decadron)]] 20 mg IV 30 minutes prior to [[Paclitaxel (Taxol)]]
 +
*[[Diphenhydramine (Benadryl)]] 50 mg IV 30 minutes prior to [[Paclitaxel (Taxol)]]
 +
*[[Cimetidine (Tagamet)]] 300 mg IV 30 minutes prior to [[Paclitaxel (Taxol)]]
  
−
Supportive medications:
+
'''21-day cycle for 4 to 8 cycles'''
−
*[[Dexamethasone (Decadron)]] 20 mg PO 12 hours and 4 hours prior to paclitaxel
 
−
*[[Dexamethasone (Decadron)]] 20 mg IV 30 minutes prior to paclitaxel
 
−
*[[Diphenhydramine (Benadryl)]] 50 mg IV 30 minutes prior to paclitaxel
 
−
*[[Cimetidine (Tagamet)]] 300 mg IV 30 minutes prior to paclitaxel
 
  
 
===References===
 
===References===
Line 394: Line 445:
  
 
=Squamous cell carcinoma=
 
=Squamous cell carcinoma=
−
==Cisplatin, Docetaxel, Fluorouracil (5-FU) {{#subobject:3f05e4|Regimen=1}}==
+
==Cisplatin, Docetaxel, Fluorouracil {{#subobject:3f05e4|Regimen=1}}==
 
{| class="wikitable" style="float:right; margin-left: 5px;"
 
{| class="wikitable" style="float:right; margin-left: 5px;"
 
|-
 
|-
Line 400: Line 451:
 
|}
 
|}
 
===Regimen {{#subobject:2ae092|Variant=1}}===
 
===Regimen {{#subobject:2ae092|Variant=1}}===
−
''The NCCN, Occult Primary version 1.2012 lists this as a suitable regimen in this setting. The Pointreau et al. 2009 regimen was for larynx and hypopharynx cancer, and the regimen also involved chemoradiation +/- surgery.''
+
''The NCCN, Occult Primary version 1.2012 lists this as a suitable regimen in this setting. The Pointreau et al. 2009 regimen was for larynx and hypopharynx cancer, and the regimen also involved chemoradiation +/- surgery.''
−
*[[Cisplatin (Platinol)]] 75 mg/m2 IV on day 1
+
====Chemotherapy====
−
*[[Docetaxel (Taxotere)]] 75 mg/m2 IV on day 1
+
*[[Cisplatin (Platinol)]] 75 mg/m<sup>2</sup> IV once on day 1
−
*[[Fluorouracil (5-FU)]] 750 mg/m2/day IV continuous infusion over 120 hours on days 1-5
+
*[[Docetaxel (Taxotere)]] 75 mg/m<sup>2</sup> IV once on day 1
 +
*[[Fluorouracil (5-FU)]] 750 mg/m<sup>2</sup>/day IV continuous infusion over 120 hours on days 1 to 5
  
−
'''21-day cycles x 3 cycles'''
+
====Supportive medications====
 +
*1 liter normal saline before and after [[Cisplatin (Platinol)]] +/- mannitol, potassium chloride, magnesium sulfate
 +
*[[Dexamethasone (Decadron)]] 8 mg PO once per day the day before, the day of, and day after chemotherapy
 +
*[[Ciprofloxacin (Cipro)]] 1000 mg PO (reference did not specify, but assume 500 mg BID) on days 5 to 15
  
−
Supportive medications:
+
'''21-day cycle for 3 cycles'''
−
*1 liter normal saline before and after cisplatin +/- mannitol, potassium chloride, magnesium sulfate
 
−
*[[Dexamethasone (Decadron)]] 8 mg PO daily the day before, the day of, and day after chemotherapy
 
−
*Ciprofloxacin (Cipro) 1000 mg PO (reference did not specify, but assume 500 mg BID) on days 5-15
 
  
 
===References===
 
===References===
 
# Pointreau Y, Garaud P, Chapet S, Sire C, Tuchais C, Tortochaux J, Faivre S, Guerrif S, Alfonsi M, Calais G. Randomized trial of induction chemotherapy with cisplatin and 5-fluorouracil with or without docetaxel for larynx preservation. J Natl Cancer Inst. 2009 Apr 1;101(7):498-506. Epub 2009 Mar 24. [http://jnci.oxfordjournals.org/content/101/7/498.long link to original article] '''contains verified protocol'''--see comment above [http://www.ncbi.nlm.nih.gov/pubmed/19318632 PubMed]
 
# Pointreau Y, Garaud P, Chapet S, Sire C, Tuchais C, Tortochaux J, Faivre S, Guerrif S, Alfonsi M, Calais G. Randomized trial of induction chemotherapy with cisplatin and 5-fluorouracil with or without docetaxel for larynx preservation. J Natl Cancer Inst. 2009 Apr 1;101(7):498-506. Epub 2009 Mar 24. [http://jnci.oxfordjournals.org/content/101/7/498.long link to original article] '''contains verified protocol'''--see comment above [http://www.ncbi.nlm.nih.gov/pubmed/19318632 PubMed]
  
−
==Cisplatin, Paclitaxel, Fluorouracil (5-FU) {{#subobject:71face|Regimen=1}}==
+
==Cisplatin, Fluorouracil, Paclitaxel {{#subobject:71face|Regimen=1}}==
 
{| class="wikitable" style="float:right; margin-left: 5px;"
 
{| class="wikitable" style="float:right; margin-left: 5px;"
 
|-
 
|-
Line 421: Line 473:
 
|}
 
|}
 
===Regimen {{#subobject:c82ab5|Variant=1}}===
 
===Regimen {{#subobject:c82ab5|Variant=1}}===
−
''The NCCN, Occult Primary version 1.2012 lists this as a suitable regimen in this setting. The Hitt et al. 2005 regimen was for head and neck cancer, and the regimen also involved chemoradiation.''
+
''Note: The NCCN, Occult Primary version 1.2012 lists this as a suitable regimen in this setting. The Hitt et al. 2005 regimen was for head and neck cancer, and the regimen also involved chemoradiation.''
−
*[[Cisplatin (Platinol)]] 100 mg/m2 IV on day 2
+
====Chemotherapy====
−
*[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours on day 1
+
*[[Cisplatin (Platinol)]] 100 mg/m<sup>2</sup> IV once on day 2
−
*[[Fluorouracil (5-FU)]] 500 mg/m2/day IV continuous infusion over 120 hours on days 2-6
+
*[[Fluorouracil (5-FU)]] 500 mg/m<sup>2</sup>/day IV continuous infusion over 120 hours on days 2 to 6
 +
*[[Paclitaxel (Taxol)]] 175 mg/m<sup>2</sup> IV over 3 hours once on day 1
  
−
'''21-day cycles x 3 cycles'''
+
====Supportive medications====
 +
*[[Dexamethasone (Decadron)]] 30 minutes before [[Paclitaxel (Taxol)]]
 +
*[[Diphenhydramine (Benadryl)]] 30 minutes before [[Paclitaxel (Taxol)]]
 +
*[[Cimetidine (Tagamet)]] or [[Ranitidine (Zantac)]] 30 minutes before [[Paclitaxel (Taxol)]]
  
−
Supportive medications:
+
'''21-day cycle for 3 cycles'''
−
*[[Dexamethasone (Decadron)]], Diphenhydramine (Benadryl), and Cimetidine (Tagamet) or Ranitidine (Zantac) 30 minutes before paclitaxel
 
  
 
===References===
 
===References===
Line 437: Line 492:
 
*Poorly differentiated or small cell tumors can be treated with [[small cell lung cancer]] regimens.
 
*Poorly differentiated or small cell tumors can be treated with [[small cell lung cancer]] regimens.
 
*Moderate to well-differentiated neuroendocrine tumors can be treated with regimens for [[neuroendocrine tumors]].
 
*Moderate to well-differentiated neuroendocrine tumors can be treated with regimens for [[neuroendocrine tumors]].
 +
 +
[[Category:Chemotherapy regimens]]
 +
[[Category:Solid oncology regimens]]

Revision as of 21:31, 21 August 2016

Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer.

Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are invited to contribute to the site.

Unknown primary tumor may also be referred to as carcinoma of unknown primary site, cancer of unknown primary (CUP), occult primary, or unknown primary carcinoma.

15 regimens on this page
16 variants on this page


Adenocarcinoma or carcinoma NOS (not otherwise specified)

Bevacizumab & Erlotinib

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Regimen

Study Evidence
Hainsworth et al. 2007 Phase II

Chemotherapy

  • Bevacizumab (Avastin) 10 mg/kg IV once per day on days 1 & 15
    • Infusion time is 90 minutes for the first dose, then if tolerated, 60 minutes for the second dose, and 30 minutes for the third dose and later
  • Erlotinib (Tarceva) 150 mg PO on days 1 to 28, 1 hour before or 2 hours after meals

28-day cycles

References

  1. Hainsworth JD, Spigel DR, Farley C, Thompson DS, Shipley DL, Greco FA; Minnie Pearl Cancer Research Network. Phase II trial of bevacizumab and erlotinib in carcinomas of unknown primary site: the Minnie Pearl Cancer Research Network. J Clin Oncol. 2007 May 1;25(13):1747-52. link to original article contains verified protocol PubMed

Bleomycin, Cisplatin, Etoposide

back to top

Regimen

Study Evidence
Hainsworth et al 1992 Phase II

Chemotherapy

21-day cycles

References

  1. Hainsworth JD, Johnson DH, Greco FA. Cisplatin-based combination chemotherapy in the treatment of poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown primary site: results of a 12-year experience. J Clin Oncol. 1992 Jun;10(6):912-22. link to original article contains verified protocol PubMed

Carboplatin & Docetaxel

back to top

Regimen #1

Study Evidence
Pentheroudakis et al. 2008 Phase II

Chemotherapy

Supportive medications

21-day cycle for up to 8 cycles

Regimen #2

Study Evidence
Greco et al. 2000 Phase II

Chemotherapy

Supportive medications

21-day cycle for 4 to 8 cycles

References

  1. Greco FA, Erland JB, Morrissey LH, Burris HA 3rd, Hermann RC, Steis R, Thompson D, Gray J, Hainsworth JD. Carcinoma of unknown primary site: phase II trials with docetaxel plus cisplatin or carboplatin. Ann Oncol. 2000 Feb;11(2):211 to 5. link to original article contains verified protocol PubMed
  2. Pentheroudakis G, Briasoulis E, Kalofonos HP, Fountzilas G, Economopoulos T, Samelis G, Koutras A, Karina M, Xiros N, Samantas E, Bamias A, Pavlidis N; Hellenic Cooperative Oncology Group. Docetaxel and carboplatin combination chemotherapy as outpatient palliative therapy in carcinoma of unknown primary: a multicentre Hellenic Cooperative Oncology Group phase II study. Acta Oncol. 2008;47(6):1148-55. link to original article contains verified protocol PubMed

Carboplatin, Gemcitabine, Paclitaxel

back to top

Regimen

Study Evidence
Greco et al. 2002 Phase II

Chemotherapy

Supportive medications

21-day cycles

References

  1. Greco FA, Burris HA 3rd, Litchy S, Barton JH, Bradof JE, Richards P, Scullin DC Jr, Erland JB, Morrissey LH, Hainsworth JD. Gemcitabine, carboplatin, and paclitaxel for patients with carcinoma of unknown primary site: a Minnie Pearl Cancer Research Network study. J Clin Oncol. 2002 Mar 15;20(6):1651-6. link to original article contains verified protocol PubMed

Carboplatin & Paclitaxel

back to top

Regimen

Study Evidence
Briasoulis et al. 2000 Phase II

Chemotherapy

Supportive medications

21-day cycle for 6 to 8 cycles

References

  1. Briasoulis E, Kalofonos H, Bafaloukos D, Samantas E, Fountzilas G, Xiros N, Skarlos D, Christodoulou C, Kosmidis P, Pavlidis N. Carboplatin plus paclitaxel in unknown primary carcinoma: a phase II Hellenic Cooperative Oncology Group Study. J Clin Oncol. 2000 Sep;18(17):3101-7. link to original article contains verified protocol PubMed

Cisplatin (Platinol)

back to top

Regimen

Study Evidence Comparator
Gross-Goupil et al. 2012 (GEFCAPI 02) Randomized Phase II Cisplatin & Gemcitabine

Chemotherapy

21-day cycles

References

  1. Gross-Goupil M, Fourcade A, Blot E, Penel N, Négrier S, Culine S, Chaigneau L, Lesimple T, Priou F, Lortholary A, Kaminsky MC, Provencal J, Voog E, Bouzy J, Laplanche A, Fizazi K. Cisplatin alone or combined with gemcitabine in carcinomas of unknown primary: results of the randomised GEFCAPI 02 trial. Eur J Cancer. 2012 Mar;48(5):721-7. Epub 2012 Feb 6. link to original article contains verified protocol PubMed

Cisplatin & Docetaxel

back to top

Regimen

Study Evidence
Greco et al. 2000 Phase II

Chemotherapy

Supportive medications

21-day cycle for up to 8 cycles

References

  1. Greco FA, Erland JB, Morrissey LH, Burris HA 3rd, Hermann RC, Steis R, Thompson D, Gray J, Hainsworth JD. Carcinoma of unknown primary site: phase II trials with docetaxel plus cisplatin or carboplatin. Ann Oncol. 2000 Feb;11(2):211 to 5. link to original article contains verified protocol PubMed

Cisplatin & Gemcitabine

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Regimen

Study Evidence Comparator
Culine et al. 2003 (GEFCAPI 01) Randomized Phase II Cisplatin & Irinotecan
Gross-Goupil et al. 2012 (GEFCAPI 02) Randomized Phase II Cisplatin

Chemotherapy

21-day cycles

References

  1. Culine S, Lortholary A, Voigt JJ, Bugat R, Théodore C, Priou F, Kaminsky MC, Lesimple T, Pivot X, Coudert B, Douillard JY, Merrouche Y, Allouache J, Goupil A, Négrier S, Viala J, Petrow P, Bouzy J, Laplanche A, Fizazi K; Trial for the French Study Group on Carcinomas of Unknown Primary (GEFCAPI 01). Cisplatin in combination with either gemcitabine or irinotecan in carcinomas of unknown primary site: results of a randomized phase II study--trial for the French Study Group on Carcinomas of Unknown Primary (GEFCAPI 01). J Clin Oncol. 2003 Sep 15;21(18):3479-82. link to original article contains verified protocol PubMed content property of HemOnc.org
  2. Gross-Goupil M, Fourcade A, Blot E, Penel N, Négrier S, Culine S, Chaigneau L, Lesimple T, Priou F, Lortholary A, Kaminsky MC, Provencal J, Voog E, Bouzy J, Laplanche A, Fizazi K. Cisplatin alone or combined with gemcitabine in carcinomas of unknown primary: results of the randomised GEFCAPI 02 trial. Eur J Cancer. 2012 Mar;48(5):721-7. Epub 2012 Feb 6. link to original article contains verified protocol PubMed

Cisplatin & Irinotecan

back to top

Regimen

Study Evidence Comparator
Culine et al. 2003 (GEFCAPI 01) Randomized Phase II Cisplatin & Gemcitabine

Chemotherapy

21-day cycles

References

  1. Culine S, Lortholary A, Voigt JJ, Bugat R, Théodore C, Priou F, Kaminsky MC, Lesimple T, Pivot X, Coudert B, Douillard JY, Merrouche Y, Allouache J, Goupil A, Négrier S, Viala J, Petrow P, Bouzy J, Laplanche A, Fizazi K; Trial for the French Study Group on Carcinomas of Unknown Primary (GEFCAPI 01). Cisplatin in combination with either gemcitabine or irinotecan in carcinomas of unknown primary site: results of a randomized phase II study--trial for the French Study Group on Carcinomas of Unknown Primary (GEFCAPI 01). J Clin Oncol. 2003 Sep 15;21(18):3479-82. link to original article contains verified protocol PubMed

Docetaxel & Gemcitabine

back to top

Regimen

Study Evidence
Pouessel et al. 2004 Phase II

Chemotherapy

Supportive medications

21-day cycle for up to 6 cycles

References

  1. Pouessel D, Culine S, Becht C, Ychou M, Romieu G, Fabbro M, Cupissol D, Pinguet F. Gemcitabine and docetaxel as front-line chemotherapy in patients with carcinoma of an unknown primary site. Cancer. 2004 Mar 15;100(6):1257-61. link to original article contains verified protocol PubMed

Gemcitabine & Irinotecan

back to top

Regimen

Study Evidence Comparator
Hainsworth et al. 2010 Phase III PCE

Chemotherapy

21-day cycle for up to 6 cycles

References

  1. Hainsworth JD, Spigel DR, Clark BL, Shipley D, Thompson DS, Farley C, West-Osterfield K, Lane CM, Cescon T, Bury MJ, Greco FA. Paclitaxel/carboplatin/etoposide versus gemcitabine/irinotecan in the first-line treatment of patients with carcinoma of unknown primary site: a randomized, phase III Sarah Cannon Oncology Research Consortium Trial. Cancer J. 2010 Jan-Feb;16(1):70-5. link to original article PubMed

PCE

back to top

PCE: Paclitaxel, Carboplatin, Etoposide

Regimen

Study Evidence Comparator
Greco et al. 2000 Phase II
Hainsworth et al. 2010 Phase III Gemcitabine & Irinotecan

Chemotherapy

Supportive medications

21-day cycle for 4 to 8 cycles

References

  1. Greco FA, Burris HA 3rd, Erland JB, Gray JR, Kalman LA, Schreeder MT, Hainsworth JD. Carcinoma of unknown primary site. Cancer. 2000 Dec 15;89(12):2655-60. link to original article contains verified protocol PubMed
  2. Hainsworth JD, Spigel DR, Clark BL, Shipley D, Thompson DS, Farley C, West-Osterfield K, Lane CM, Cescon T, Bury MJ, Greco FA. Paclitaxel/carboplatin/etoposide versus gemcitabine/irinotecan in the first-line treatment of patients with carcinoma of unknown primary site: a randomized, phase III Sarah Cannon Oncology Research Consortium Trial. Cancer J. 2010 Jan-Feb;16(1):70-5. link to original article PubMed

Squamous cell carcinoma

Cisplatin, Docetaxel, Fluorouracil

back to top

Regimen

The NCCN, Occult Primary version 1.2012 lists this as a suitable regimen in this setting. The Pointreau et al. 2009 regimen was for larynx and hypopharynx cancer, and the regimen also involved chemoradiation +/- surgery.

Chemotherapy

Supportive medications

21-day cycle for 3 cycles

References

  1. Pointreau Y, Garaud P, Chapet S, Sire C, Tuchais C, Tortochaux J, Faivre S, Guerrif S, Alfonsi M, Calais G. Randomized trial of induction chemotherapy with cisplatin and 5-fluorouracil with or without docetaxel for larynx preservation. J Natl Cancer Inst. 2009 Apr 1;101(7):498-506. Epub 2009 Mar 24. link to original article contains verified protocol--see comment above PubMed

Cisplatin, Fluorouracil, Paclitaxel

back to top

Regimen

Note: The NCCN, Occult Primary version 1.2012 lists this as a suitable regimen in this setting. The Hitt et al. 2005 regimen was for head and neck cancer, and the regimen also involved chemoradiation.

Chemotherapy

Supportive medications

21-day cycle for 3 cycles

References

  1. Hitt R, López-Pousa A, Martínez-Trufero J, Escrig V, Carles J, Rizo A, Isla D, Vega ME, Martí JL, Lobo F, Pastor P, Valentí V, Belón J, Sánchez MA, Chaib C, Pallarés C, Antón A, Cervantes A, Paz-Ares L, Cortés-Funes H. Phase III study comparing cisplatin plus fluorouracil to paclitaxel, cisplatin, and fluorouracil induction chemotherapy followed by chemoradiotherapy in locally advanced head and neck cancer. J Clin Oncol. 2005 Dec 1;23(34):8636-45. Epub 2005 Nov 7. link to original article contains verified protocol--see comment above PubMed

Neuroendocrine tumors

Retrieved from "https://hemonc.org/w/index.php?title=Carcinoma_of_unknown_primary&oldid=11519"