Research conducted at The Christie NHS Foundation Trust in Manchester shows it’s possible to identify patients with CUP (cancer of unknown primary) who have a “hidden” bile duct cancer, which could improve outcomes and treatment options for these patients. By reclassifying the patient as having biliary tract cancer, they can be offered the right chemotherapy and personalised medicine options.
CUP is the fifth leading cause of cancer death in the UK, and the majority of patients diagnosed with this type of cancer have a poor prognosis due to the cancer being diagnosed at late stage. Many of these patients have cancer in the liver and around a third of these could have hidden bile duct cancer.
Christie researchers studied data from 228 Christie patients with CUP and found that if the cancer in the biliary tract (bile duct) is discovered sooner, patients will have access to the appropriate chemotherapy treatments, genetic testing, and some accessing treatment with targeted therapies designed for biliary tract cancer far faster.
Dr Natalie Cook, medical oncologist, who is leading the research into CUP at The Christie, said: “CUP remains a significant cause of cancer death in the UK and there is still so much we need to understand about this type of cancer. To bring a personalised approach to treatment is a step change in our work to improve outcomes for patients.
"By reclassifying some of those CUP patients with cancer in the liver as bile duct cancer patients, this would lead to increased treatment options and a better prognosis. We found a third of patients with liver-involved CUP fell into this category. A timely diagnosis, identifying any chemo-responsive tumour types and targetable mutations, could lead to improved survival rates.”
Professor Juan Valle, medical oncologist at The Christie, specialising in biliary tract cancer, said: “This is a fantastic piece of work by 2 teams at The Christie working in collaboration to study data, genomics and patient profiling. These combined efforts could improve the life expectancy for CUP patients who invariably have a very poor prognosis due to their cancer being difficult to detect. We are very pleased to be able to share our learnings with our colleagues in cancer centres worldwide because identifying biliary tract cancer in the liver is essential.”