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BioMed Central Blog

Wednesday Sep 28, 2011

Tracking down cancers of unknown primary origin

In some cases of cancer, the major challenge is to identify the site at which the cancer initially arose. A cancer of unknown primary origin (CUP) refers to a disorder in which the location of the primary tumor remains a mystery, even after routine diagnostic tests and biopsy. Not knowing the primary source of a cancer can setback the development of an effective treatment plan for the patient and reduce their overall chance of survival. This week in Genome Medicine, Olli Kallioniemi and colleagues at the University of Helsinki present an improved method for pinpointing the tissue origin of a primary tumor, using gene expression data. Their method could improve the accuracy of diagnosis and pave the way for tailored anti-cancer therapy in CUP patients.

A number of methods for predicting the site of tumor origin have been described, and most of these compare the gene expression profile of the CUP sample with a “reference set” of tumor-specific hallmarks. These conventional approaches rely on an a priori defined set of genes, limiting the adaptability of the method to emerging information about specific cancers. The method described by Kallioniemi and colleagues, wAGEP (weighted Alignment of Gene Expression Profiles) can be adapted to any reference dataset, allowing it to be continually optimized as new tumor expression data becomes available. As well as being flexible, wAGEP proved to be highly accurate in classifying tumor samples according to tissue origin.

Another key advantage of wAGEP is that it  can be used to investigate a CUP case on a gene-by-gene level, so provides information about the individual genes involved in initiating the cancer and also driving its spread to different tissue types (metastasis).  Every cancer is unique and its evolution can be multifaceted, but by defining some of the systematic changes involved, novel molecular predictors could be revealed.

The method described is accurate, scalable and enables gene-by-gene analysis of cancers of unknown primary origin. Application of wAGEP in a clinical setting could allow the rapid diagnosis of unclassified cancers and implementation of personalized treatment regimes.


 

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