Carcinoma of Unknown Primary (CUP)
I Choose OncoPredict PrimArray
OncoPredict PrimArray is a selective panel for Cancer of Unknown Primary, including
- the detection of 35 genes, mutations associated with cancers of various organs.
- Determination of microsatellite instability MMR/MSI of the tumor
- Calculation of TMB Tumor Mutational Burden
- Detection of PD-L1 immunoassay expression
In case your sample is not already in microDiagnostics Ltd’s archives, Contact us to arrange safe and fast shipping to our laboratory.
Consult your Oncologist to get the best possible choice for you and personalized treatment.
I Choose OncoDx PrimArray
OncoDx PrimArray is a test based on a diagnostic immunohistochemical algorithm and involves patients with Cancer of Unknown Primary site (CUP). This algorithm is fully compliant with the guidelines of the National Comprehensive Cancer Network (NCCN), according to which the pathologist uses specific immunohistochemistry (IHC) antibodies, with the sole aim of concluding to a Diagnosis. With such a diagnostic algorithm, it is possible to identify the primary site of the tumor (primary location, source of metastatic tumor origin).
In case your sample is not already in microDiagnostics Ltd’s archives Contact us to arrange safe and fast shipping to our laboratory.
Consult your Oncologist to get the best possible choice for you and personalized treatment.
What is the clinical utility of OncoPredict PrimArray?
In any case of CUP, the clinical and histopathological findings will contribute to the selection of the most appropriate treatment option. The histological examination and the potential discovery of gene mutations (determination of the molecular tumor profile) will help the oncologist to choose the best possible treatment (targeted therapy or immunotherapy against chemotherapy, or combinations thereof).
What is the clinical utility of OncoDx PrimArray?
OncoDx PrimArray is carried out for the diagnosis of the tumor.
If the tumor is perceived only as metastasis to any part of the body (e.g. lymph nodes), it is vital:
- Performing a biopsy from the metastasis site (core biopsy or FNAB, or EBUS)
- Histological examination or cytological examination with cell block
- Thorough immunohistochemical testing on biopsy material to make a histological or cytological diagnosis.
Histological/cytological diagnosis aims to determine:
- the histological type of tumor (carcinoma, sarcoma, melanoma, lymphoma)
- the histological subtype of the tumor (adenocarcinoma, squamous cell carcinoma, mucinous carcinoma, carcinosarcoma, large cell carcinoma, neuroendocrine carcinoma, etc.).
The identification of the type of the tumor is of the utmost importance because it will determine the surgical, radiotherapeutic, pharmaceutical treatment option, as it will also give an overview of the biological behavior of the tumor.
MicroDiagnostics Ltd has the most updated library of immunohistochemical antibodies (see table), based on which it exercises the diagnostic algorithm.
The diagnostic algorithm does not include more than 10-12 antibodies, according to each case examined.
CD4 | CD8 | CD56 | CD57 | CD45RO | CD16 | CD68 | CD34 | CD10 | CD20 |
CD3 | CD30/Ki1 | CD45RA | CD45/LCA | CD5 | CD19 | CD5ob | CD23ob | CD23 | CD15 |
CD79a | CD33 | CD31 | CK18/8 | κ | λ | K ob | λ ob | PSA | HMB45 |
CDAE1/AE3 | VIMENTIM | DESMIN | SMA | S100 | EMA | CEA | GFAP | SYNAPTO | P53 |
ER | PR | HER2 | Ki67 | EGFR | ECADHERIN | CK5/6 | CK7 | CK20 | CYTOCER |
CK34BE12 | CKIT/CD117 | GCDFP15 | CDX2 | a-INHIBIN | TTF1 | PLAP | THYROGLOB | MPO/MYELO | NSE |
AMACR | BCL2 | BCL6 | CHROMO | HAIRYCELL | CYCLIND1 | CD99 | LYSOZYME | MelanA | P63 |
CK8 | CALCITONIN | CYTMNF | OSTEONECTIN | TOPOISOMERASE | HCG | CMV | GLYCOPHORIN | MUM1 | MUM1ob |
UROPLAKIN | CK34P63 | VWF/FV8 | CA125 | MyF4 | CA19-9 | VILLIN | CALRETININ | h-CALDESMON | FLEX/HEPATOCYTE |
SMOOTHELIN | P120 | CK19 | MUC5AC | COLLAGENIV | DOG1 | D22 | Bob1 | NAPSIN A | Mast cell tryptase |
Glypican 3 | TdT | WT1 | D2-40 | MLH1 | MSH2 | PMS2 | MSH6 | IMSM1 |
What sample is needed & how are OncoPredict & OncoDx PrimArray performed in MicroDiagnostics Ltd?
OncoPredict & OncoDx PrimArray tests are performed on the surgical specimen or on the biopsy material (paraffin blocks – FFPE) on which your histological examination was performed on or on thecytology material (FNAB, EBUS) that your cytological examination was performed.
In case your sample is not already in microDiagnostics Ltd archives Contact us to arrange safe and fast shipping to our laboratory.
You will also need to complete easily and quickly a Consent Form.
In our fully verticalized Laboratory, the pathologist selects the most appropriate paraffin block out of the many that may have been created (microdissection).
One-touch approach – Strategic sample management, Time saving
At our vertically integrated Lab, we handle your sample in such a way as to minimize unnecessary waste:
- One-Touch: Your sample is being processed once (and not repeatedly) by experienced histotechnologists, after first checking its adequacy with the Pathologist.
- Material is obtained successively in such a way as to ensure diagnosis, immunohistochemistry & molecular tests.
- Enrichment to ensure the maximum possible number of cancer cells, which could affect the validity of the results, performed by pathologists.
- The molecular biologist immediately processes the sample in a fully controlled environment, using next-generation sequencing (NGS) or real-time PCR to detect mutations in the genes we are interested in, or by the method of immunohistochemistry (IHC) on a certified platform to control tumor protein expression.
Which are the most commonly associated cancers with genes mutation on the OncoPredict PrimArray panel?
Cancers that are statistically most often associated with mutations in genes of the OncoPredict PrimArray panel are indicative of:
- Colorectal cancer
- Lung cancer
- Breast cancer
- Ovarian cancer
- Endometrial Cancer
- Pancreatic cancer
- Stomach cancer
- Prostate gland cancer
- Head and Neck Cancers
- Melanoma
What do we call Cancer of Unknown Primary (CUP)?
Cancer begins when the body’s cells begin to multiply uncontrollably. Cells in any part of the body may develop as cancers and may spread from their original site (the part of the body where cancer started – primary focus) to one or more metastatic sites (other parts of the body).
Sometimes it is not clear where cancer originated. When cancer is located in one or more metastatic sites but the primary site of origin cannot be determined, i.e. the primary site from which it originated, then it is called Cancer of Unknown Primary – CUP.
What is the prognosis of a Cancer of Unknown Primary (CUP)?
The prognosis for patients with CUP is usually unfavorable. CUP is represented by a heterogeneous group of cancers that all have metastasized.
Although the majority of cancers are relatively resistant to systemic treatments, some cases of CUP have a much better prognosis. These cases are which molecular tests like OncoPredict PrimArray intend to highlight.
Cancer Types:
Cancer of Unknown Primary site (CUP)
Turn Around Time:
up to 2 weeks*
* In case additional enrichment of the material is required, for the successful results of the tests, we will contact you.
Frequently Asked Questions (FAQ)
OncoPredict & OncoDx PrimArray tests are performed on the surgical specimen, or on the biopsy material (paraffin blocks – FFPE) that your histological examination was performed or on the cytology material (FNAB, EBUS) that your cytological examination was performed.
In case your sample is not already in the microDiagnostics’ Ltd archives, Contact us to undertake its safe and fast transfer to our laboratory.
Sometimes the sample material we are called to handle is minimum because it has resulted from a minimally invasive method (needle biopsy, fluid puncture, FNAB, EBUS e.t.c).
In our laboratory, pathologists check whether the material is sufficient. If so, then a management algorithm follows, in order to succeed:
to perform multiple tests on the material (Immunohistochemistry, real-time PCR, NGS) in order to fully detect and highlight the molecular profile of the tumor (proteins, genes, histological Grading)
In this case and if the enrichment manipulations of the sample have been ceased, we contact your clinical doctor to discuss alternative approaches in order to extract the desired information for the selection of the optimal treatment for you. Some examples:
Perform an alternative examination (e.g. Immunohistochemistry instead of PCR, or Next Generation Sequencing – NGS)
Implementation of Immunohistochemistry instead of FISH (Fluorescent In Situ Hybridization)
Possible blood sampling instead of tissue examination (liquid biopsy)
Possible choice of a new biopsy or puncture
Through constant contact and communication with your treating physicians (Oncologist, Surgeon, Interventional Radiologist, Radiotherapist, etc.) and within the framework of Interdisciplinary Meetings, the following can be decided:
sample availability,
histological diagnosis,
cytological diagnosis,
overall health,
the prognostic profile of the disease
Contact the molecular diagnostics service department:
Contact Phone: +30 2310 23 22 72
credit/debit card, online interbank deposit
One of the primary concerns of microDiagnostics’ Ltd is the protection of your personal data as well as the strict adherence to the conditions protecting your genetic material and medical results.
In full compliance with the General Data Protection Regulation (GDPR) we ensure that you are aware and conscious for any examination will be conducted and we do not announce results via phone calls.
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