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Occult primary, version 3.2014.

David S Ettinger1, Charles R Handorf1, Mark Agulnik1

  • 1From The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; University of Colorado Cancer Center; Vanderbilt-Ingram Cancer Center; City of Hope Comprehensive Cancer Center; Fox Chase Cancer Center; Fred Hutchinson Cancer Research Center/Seattle Cancer Center Alliance; Massachusetts General Hospital Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Huntsman Cancer Institute at the University of Utah; University of Alabama at Birmingham Comprehensive Cancer Center; Roswell Park Cancer Institute; The University of Texas MD Anderson Cancer Center; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute; Memorial Sloan Kettering Cancer Center; UC San Diego Moores Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; University of Michigan Comprehensive Cancer Center; Duke Cancer Institute; Moffitt Cancer Center; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; and National Comprehensive Cancer Network.

Journal of the National Comprehensive Cancer Network : JNCCN
|July 5, 2014
PubMed
Summary
This summary is machine-generated.

The NCCN Guidelines for Occult Primary tumors recommend against gene expression profiling (GEP) for routine cancer management due to unproven clinical benefit. While GEP aids diagnosis, its impact on patient outcomes requires further demonstration.

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Area of Science:

  • Oncology
  • Clinical Guidelines

Background:

  • Occult primary tumors (cancers of unknown primary) present diagnostic and management challenges.
  • The National Comprehensive Cancer Network (NCCN) provides guidelines for these complex cases.

Framework:

  • The 2014 NCCN Occult Primary panel meeting focused on evaluating advanced diagnostic tools.
  • Key discussion points included gene expression profiling (GEP) and testing for actionable mutations.

Implementation:

  • GEP was discussed for identifying the tissue of origin in cancers of unknown primary.
  • The panel concluded GEP offers diagnostic but not demonstrated clinical benefit, recommending against its routine use.
  • A minority (20%) supported GEP's routine use based on diagnostic value.

Implications:

  • Current NCCN guidelines do not support routine GEP for occult primary tumors.
  • Testing for actionable mutations to guide therapy was also considered but not recommended at this time.
  • Further research may clarify the clinical utility of GEP in this patient population.