title: Second-line chemotherapy in patients with primary unknown cancer.
abstract: OBJECTIVE
  There are few existing reports on the efficacy of second-line chemotherapy in patients with cancer of unknown primary site (CUP). The aim of this study was to identify characteristics of CUP patients linked to a positive response to chemotherapy.
  
  
  METHODS
  We retrospectively studied the clinical outcomes of second-line chemotherapy in patients with CUP who had previously been treated with platinum-based first-line chemotherapy.
  
  
  RESULTS
  A total of 27 patients received second-line chemotherapy. Of these patients, 5 (19%) showed an objective response to second-line chemotherapy; 4 of these patients had shown a favorable response to first-line chemotherapy and had a chemotherapy-free interval (CFI) of more than 4.5 months. Among the 8 patients in whom the CFI was more than 4.5 months, 4 (50%) showed an objective response to platinum-based second-line chemotherapy, whereas among the 16 patients with a CFI of less than 4.5 months, only 1 (6%) showed a response to any chemotherapeutic regimen.
  
  
  CONCLUSIONS
  The response to second-line chemotherapy in CUP patients who had received platinum-based first-line treatment seemed to be associated with the response to first-line chemotherapy and the CFI. Although it remains unclear whether second-line chemotherapy might contribute to a survival benefit in patients with CUP, patients who show a favorable response to first-line chemotherapy and also a relatively prolonged CFI appear to be likely to benefit from second-line chemotherapy.
authors.affiliation: Breast and Medical Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Ono
authors.forename: Masashi
authors.initials: M
authors.lastname: Ando
authors.forename: Kan
authors.initials: K
authors.lastname: Yonemori
authors.forename: Harukaze
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Taizo
authors.initials: T
authors.lastname: Hirata
authors.forename: Chikako
authors.initials: C
authors.lastname: Shimizu
authors.forename: Kenji
authors.initials: K
authors.lastname: Tamura
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Katsumata
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujiwara
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D016190:Carboplatin / Q000008:administration & dosage; D002277:Carcinoma / Q000188:drug therapy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy; D018572:Disease-Free Survival; D000077143:Docetaxel; D004334:Drug Administration Schedule; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D000077146:Irinotecan; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D017239:Paclitaxel / Q000008:administration & dosage; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D043823:Taxoids / Q000008:administration & dosage; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D000077146:Irinotecan; D016190:Carboplatin; D017239:Paclitaxel; D002166:Camptothecin