ESMO 2023: CUPISCO study

The CUPISCO study a phase II international study comparing the efficacy and safety of targeted therapy or cancer immunotherapy guided by genomic profiling versus platinum-based chemotherapy in patients with CUP(carcinoma of unknown primary) reported at ESMO in October 23.

The study which was open at 8 sites across the UK recruited patients with poor prognostic CUP; randomizing patients to either molecular guided therapy following comprehensive genomic profiling versus standard ofcare chemotherapy. All patients received induction chemotherapy (3 cycles) Following which they were randomised to either continuation of chemotherapyor molecular guided therapy (MGT). The data presented at ESMO correspondedto patients in the cohort that had CR/PR or SD to induction chemotherapy.

The data demonstrated an improvement in PFS (progression free survival) of 6.1months (molecularly guided therapy) versus 4.4 months (standard chemotherapy) p= 0.0079HR (95% CI): 0.72 (0.56–0.92).

The study concluded that MGT improved PFS compared with platinum-based chemotherapy in patients with CUP in this cohort of patients. That MGTs didnot increase risk (safety and QoL). It demonstrated the value of including comprehensive genomic profiling in the diagnostic work-up, to inform treatment decisions in patients with CUP; and that the use of tissue and liquid biopsies enabled more treatment options for patients with CUP.

At present the overall survival data for the study is immature but will be reported in the future in addition to the additional patient cohort group.

Please follow this link to view the poster ehibited at ESMO 2023