1. Provisional MUO Audit Tania Tillett Medical Oncologist RUH

2. Background At last meeting we agreed we were seeing a different cohort of patients at different sites We agreed a background audit to help us design and plan our services Malignancy Uncertain Origin (MUO) MUO cCUP Primary Identified Treatment Offered?

3. Network Data MUO n=185 N=31 17% MUO N= 39 21% cCUP N=115 62% Primary Found

4. Trust Data – MUO n=185

5. Median age across Trusts (71yrs)

6. Where patients are seen?

7. Patients who get a biopsy (60% median)

8. Patients confirmed cCUP

9. Difficulties with data We are not all looking at the same population of patients ?More conformity of referral requirements No biopsy but confirmed diagnosis ?Cytology or best guess Where to draw the line between cCUP and primary “looks like metastatic CR” “treated like H+N”

10. How did we treat cCUP? (n=40)

11. Which chemotherapy regimes?

12. More questions than answers These are a heterogeneous group and so heterogeneous treatment is understandable but how do we measure safety or consistency? Which direction shall we go now?