Carcinoma of Unknown Primary Site (CUP) a comparison across tissue and liquid biomarkers (CUP-COMP)

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Patients with Carcinoma of Unknown Primary (CUP) have widespread cancer at diagnosis however the specific site of origin cannot be found making it difficult to treat. CUP is a common cancer with a poor prognosis. It is the 6th most common cause of cancer death in the UK. Every day approximately 20 people are diagnosed and 30 people die from CUP (CRUK Statistics).CUP demands that we integrate everything we know about the patient's cancer: patient's symptoms, blood test results, radiological imaging and pathology results are all currently used as standard diagnostics to make clinical decisions for CUP patients. To date there have been limited studies investigating molecular genomics in CUP patients, as a result we have limited evidence to evaluate whether genomic profiling has added value over and above the standard diagnostics provided in the NHS.As a result, our project will focus on addressing the following;* Assessment of genomic sequencing (both in tissue and blood) for the diagnosis and treatment stratification in patients with CUP including a comparison of the effectiveness of tissue and blood based biomarkers* Collection of evidence to further develop technology that predicts an individual's response to a treatment* Development of innovative systems of clinical data capture in patients with CUP* Investigation into novel biomarkers to determine the primary tumour locationThis collaboration unites experts from 7 academic institutions linked to NHS Hospitals and Cancer Research UK, a pharmaceutical company with access to a number of novel therapeutics (Roche), expert data management (ConcR) alongside patient representatives from the CUP Foundation Jo's Friends.The UK CUP Investigators are dedicated to improving prognosis and access to treatments in CUP. In order to make further progress for our patients we need to be able to consent and molecularly profile increased numbers of patients. This project will aim to enroll patients across all subtypes of CUP, gathering evidence for the multitude of questions that remain unanswered. The genomic and longitudinal clinical data that will be collected would be the first dataset to include multi-omic and clinical data and could be used to drive additional research in the UK. It would address an area of high unmet need and has the potential to change clinical care.