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SEOM-GECOD clinical guideline for cancer of unknown primary (update 2025)

Ferrán Losa1, Olatz Etxaniz2, Alejandra Giménez3

  • 1Hospital de Sant Joan Despí Moisés Broggi-ICO Hospitalet, Barcelona, Spain. flosa@csi.cat.

Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
|March 10, 2026
PubMed

Insights

Cancer of unknown primary (CUP) diagnosis and treatment are evolving. Routine genomic testing in CUP patients can guide personalized therapies and improve outcomes for this complex cancer type.

Area of Science:

  • Oncology
  • Genomics
  • Translational Medicine

Background:

  • Cancer of unknown primary (CUP) represents a heterogeneous group of metastatic tumors where the origin remains unidentified after standard diagnostics.
  • CUP is associated with poor patient outcomes, highlighting the need for improved diagnostic and therapeutic strategies.

Purpose of the Study:

  • To provide updated guideline recommendations for the diagnosis and treatment of CUP.
  • To highlight the importance of molecular profiling in guiding personalized therapy for CUP patients.
  • To discuss advancements in molecular medicine relevant to improving outcomes in CUP.

Main Methods:

  • Review of current diagnostic work-up protocols for CUP.
  • Analysis of evidence supporting genomic alterations determination in CUP.
  • Summary of therapeutic options, including molecularly guided treatments.
  • Inclusion of recent developments in molecular medicine.

Main Results:

  • High-level evidence supports routine determination of actionable genomic alterations in CUP.
  • Molecularly guided therapy offers a promising approach for CUP management.
  • Updated guidelines incorporate diagnostic and therapeutic advancements.

Conclusions:

  • Genomic profiling is crucial for optimizing treatment strategies in Cancer of Unknown Primary.
  • Personalized medicine approaches hold potential to improve outcomes for patients with CUP.
  • Continuous updates in molecular medicine are vital for advancing CUP care.
Keywords:
CancerDiagnosisTreatmentUnknown primary site

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