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• Conference output

On this page you will find the output from the 26/27 April 2012 Conference. Firstly the output from the Scientific Advisory Board, then the summary of the presentations given on 27 April with the speakers' slides.

Scientific Advisory Board Meeting of 26 April

Hosted by the CUP Foundation, an international group of invited experts met to move forward CUP research. The Group included oncologists, laboratory and social scientists with industry representatives.

The aim of the meeting was to define a 3-year priority focus that would result in improvements in all aspects of CUP care through clinical, translational and patient-reported outcome research. The Group recognised 4 main areas of need reflecting:

• Inordinate and unnecessary delays in the diagnostic process due to inadequate application of expertise and modernised technology
• Deficiencies in the timely introduction of high quality supportive and palliative care
• Insufficient research into clinical services and therapies
• Continued uncertainty about the fundamental biology of CUP

The Group therefore proposed one over-arching, time-critical aim:

'Within 3 years the diagnostic pathway for patients presenting with malignancy of undefined primary origin (MUO) should be reduced by half the time that it’s taking at present, with the result that patients will be provided rapidly with a clear treatment pathway. During this process, they will receive world-class symptomatic and supportive care.'

The Group noted the potential emergence of a new concept in CUP that may help to structure research and treatment – that of a categorical primary-like diagnosis. It anticipated that the majority of MUO / CUP patients will be allocated a primary-like diagnosis, through the application of new technologies, by the end of the 3 year target period. To reach this goal, the following steps were identified as essential:

• Audit the diagnostic pathways now – looking at patient outcomes and experience. Comprehensive baseline data on a sizeable cohort to be available within 1-2 years
• Establish the health-utility value of implementing GEP (gene expression profiling) tests. In particular, the UK, Europe and Australia need a better indication of the effectiveness of GEP on health outcomes to make a convincing case that regular use will save money, time, and labour as well as improving outcomes
• In researching currently available modern diagnostic technologies, we should seek to:
  
  
  • Apply them routinely in a research framework in order to reduce the length of the initial diagnostic pathway by half
  • Provide a categorical ‘primary-like’ diagnosis in 80% of cases and audit outcomes
  • Provide training. Improvements in education and communication are necessary at all levels of professional medical development. CUP patient-reported outcome issues remain key. A European dimension to development of clinical skills and services is essential, and support provided by ESMO would be valuable in this regard
  • Undertake basic research. Next generation whole genome sequencing will allow us to assess CUP as the test-bed for molecularly-selected therapy rather than “histology defined” therapy as at present.  

27 April Conference summary

• Conference summary.pdf

Conference slides

• Brooks.pdf
• Greco.pdf
• Osborne.pdf
• Pavlidis.pdf
• Schofield_patient_exp.pdf
• Schofield_molecular_bio.pdf
• Vajdic.pdf
• Wagland_for_Addington-Hall.pdf
• Wasan.pdf