The malignancy of an unknown origin (MUO)/cancer of unknown primary (CUP) workstream aims to improve the quality, expertise and increase the quantity of multidisciplinary research into outcomes for people MUO, or presumed CUP or confirmed CUP diagnosis.


  1. Collate a list of MUO/CUP experts across the UK to create a database. This will help to identify national leads for CUP. Aim to capture 90% of CUP and MUO clinical and nursing leads in all UK hospitals with a CUP MDT collated from Cancer Alliances, UKONS networks and other contacts which will be updated annually
  2. Support the £1.5million programme grant via Innovate UK (CUP-COMP Carcinoma of Unknown Primary (CUP): A comparison across tissue and liquid biomarkers’ which aims to perform solid and liquid (blood) genome profiling on up to 150 patients with CUP The objectives are the:
    • Assessment of genomic sequencing (both in tissue and blood) for the diagnosis and treatment stratification in patients with CUP including a comparison of the effectiveness of tissue and blood-based biomarkers.
    • Collection of evidence to further develop technology that predicts an individual’s response to a treatment.
    • Development of innovative systems of clinical data capture in patients with CUP
  3. Understand and pose solutions to the broad challenges that patients with MUO-CUP face in terms of accessing standard and novel diagnostics and holistic care/support they require.
  4. Develop new MUO-CUP studies or trials.
    • Develop tools to capture patient-reported outcome and experience measures to enhance patient involvement, decision making and satisfaction in their care in challenging diagnostic and therapeutic environment. Continue work on CUPPA (Cancer of Unknown Primary Patient Decision Aids project
    • Prognostic and predictive biomarkers in CUP Collaborations with academic sites/biobanks and pharmaceutical/commercial diagnostic companies to increase access for patients to Studies using existing clinical biomarkers Studies to access solid tissue molecular profiling Studies to access liquid/blood biomarker molecular profiling
    • In biomarker testing
  5. Design a questionnaire to discuss evolving future of the workforce and research capabilities in each hospital/region.
  6. The Workstream fully support the recruitment of patients into the International Phase 2 CUPISCO trial, CUPem, PEACE, CUP TCGA and other studies.
  7. It will work to ensure not only primary but, exploratory objectives can be achieved for both commercial and academic studies.
  8. A network of tissue biobanks in the UK for CUP patients so that ideas and questions generated by board members and collaborators nationally and internationally can tested on existing and future tissue samples from patient with CUP