Authors
Liangshan Da, Tai Ma, Jie Da, Wanren Peng
Published in
Frontiers in oncology. Volume 16. Pages 1883469. Epub Sep 24, 2026.
Abstract
Cancer of unknown primary (CUP) is primarily treated with empirical chemotherapy, but clinical outcomes remain unsatisfactory. We present the case of a 62-year-old male with asymptomatic left supraclavicular lymphadenopathy. Fine-needle aspiration revealed metastatic poorly differentiated carcinoma. Comprehensive evaluation, including contrast-enhanced computed tomography (CT), fluorodeoxyglucose positron emission tomography/CT (FDG-PET/CT), nasopharyngoscopy, and gastroscopy, failed to identify a definite primary tumor, leading to a diagnosis of CUP. Initial empirical chemotherapy with liposomal paclitaxel and nedaplatin showed limited efficacy and was complicated by grade 3 treatment-related adverse events (TRAEs), resulting in discontinuation due to poor tolerability. Subsequently, a core needle biopsy was performed. Immunohistochemistry suggested metastatic renal cell carcinoma (RCC). A 90-gene expression assay identified the kidney as the most likely primary site, with a similarity score of 82.6. The regimen was then switched to site-specific therapy with lenvatinib plus camrelizumab. The patient tolerated treatment well, experiencing only grade 1 TRAEs. Follow-up contrast-enhanced CT scans demonstrated significant lesion regression (33.1% and 69.6% reductions at 2 and 4 months, respectively), achieving a best response of partial response (PR). In conclusion, the combination of lenvatinib and camrelizumab demonstrated a favorable short-term response and acceptable tolerability in this patient, and renal-like CUP represents a distinct favorable CUP subset.
PMID:
42851335
Bibliographic data and abstract were imported from PubMed on 09 Oct 2026.
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