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

原发性不明癌（CUP）患者在诊断时广泛存在肿瘤，但无法找到具体的起源部位，使其难以治疗。CUP是一种常见的癌症，预后较差。它是英国第六大最常见的癌症死亡原因。每天大约有20人被诊断出患有CUP， 30人死于CUP （CRUK统计）。CUP要求我们整合我们对患者癌症的所有了解：患者的症状、血液检查结果、放射成像和病理结果都是目前用于对CUP患者进行临床决策的标准诊断。迄今为止，在CUP患者中研究分子基因组学的研究有限，因此我们没有足够的证据来评估基因组谱分析是否在NHS提供的标准诊断之外增加了价值。因此，我们的项目将重点解决以下问题：*评估基因组测序（包括组织和血液）对CUP患者的诊断和治疗分层，包括比较组织和血液生物标志物的有效性*收集证据以进一步开发预测个体对治疗反应的技术*开发CUP患者临床数据捕获的创新系统*研究新的生物标志物以确定原发性肿瘤位置联合了来自7个与NHS医院和英国癌症研究相关的学术机构的专家，一家可以获得许多新疗法的制药公司（罗氏），专家数据管理（ConcR）以及来自CUP基金会Jo's Friends的患者代表。英国CUP研究人员致力于改善CUP患者的预后和治疗途径。为了使我们的患者取得进一步的进展，我们需要能够同意并对更多的患者进行分子分析。该项目旨在招募所有CUP亚型的患者，为众多尚未解决的问题收集证据。将收集的基因组和纵向临床数据将是第一个包含多组学和临床数据的数据集，可用于推动英国的其他研究。它将解决一个高度未满足需求的领域，并有可能改变临床护理。

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.