Chemotherapy

Patients with unfavorable CUP who are not candidates for molecular targeted therapy or immunotherapy are candidates for clinical trials. Cytotoxic chemotherapy can be a palliative therapy, but the choice of drugs has been based on a few small clinical studies, with no randomized trials establishing their benefit over best supportive care.[10] Several randomized prospective studies demonstrate that platinum-based doublet chemotherapy combined with a taxane or gemcitabine is equivalent to other chemotherapy in response rate and progression-free survival.[11-14][Level of evidence B1] Although most patients in these trials had adenocarcinoma or poorly differentiated carcinoma, patients with poorly differentiated squamous cell carcinoma were included.

Palliative care and hospice are options for patients with a poor performance status and relapsing disease.