CUPISCO
alectinib; vismodegib; ipatasertib in unfavourable cancer of unknown primary
Clinician commentary on CUPISCO in the sources reviewed for this edition leads to one open question: How should Medical Affairs communicate the value of early molecularly informed care while making endpoint uncertainty, treatment-specific evidence limits and feasible access explicit? Its leading findings: (1) A positive PFS result is not an established overall-survival benefit. (2) clinical magnitude and integrated-care value are different arguments. (3) the strategy result does not prove every treatment stratum or the atezolizumab add-on. 9 more findings follow. 116 sources screened, 68 cited; not all HCPs or all public discussion.
- NCT03498521 ↗
- v1.0.0 · edition 1
- updated Oct 31, 2026
- Deep
12 findings, and what sits behind each
01. A positive PFS result is not an established overall-survival benefit
18 statements · 15 passages · 10 sources · 5 named voices
Counterview: recorded · Limitations recorded: 2. Feeds the Medical Affairs question.
Draws on: Secondary endpoint: Overall Survival (OS), Primary endpoint: Progression Free Survival (PFS) as Assessed by the Investigator According to Response Evaluation Criteria In Solid Tumors v1.1 (RECIST v1.1).
02. Clinical magnitude and integrated-care value are different arguments
30 statements · 27 passages · 9 sources · 6 named voices
Counterview: recorded · Limitations recorded: 2. Feeds the Medical Affairs question.
Draws on: Primary endpoint: Progression Free Survival (PFS) as Assessed by the Investigator According to Response Evaluation Criteria In Solid Tumors v1.1 (RECIST v1.1), Design and conduct, Population and setting, Secondary endpoint: Overall Survival (OS), The comparison.
03. The strategy result does not prove every treatment stratum or the atezolizumab add-on
13 statements · 13 passages · 7 sources · 4 named voices
Counterview: recorded · Limitations recorded: 4. Feeds the Medical Affairs question.
Draws on: The comparison, Primary endpoint: Progression Free Survival (PFS) as Assessed by the Investigator According to Response Evaluation Criteria In Solid Tumors v1.1 (RECIST v1.1), Secondary endpoint: Duration of Response (DOR), Design and conduct.
04. Population selection determines comparator validity and the place of local treatment
29 statements · 29 passages · 11 sources · 5 named voices
Counterview: recorded · Limitations recorded: 2. Feeds the Medical Affairs question.
Draws on: Population and setting, Design and conduct, The comparison, Primary endpoint: Progression Free Survival (PFS) as Assessed by the Investigator According to Response Evaluation Criteria In Solid Tumors v1.1 (RECIST v1.1).
05. Early profiling is advocated alongside, not instead of, a sufficient diagnostic work-up
12 statements · 11 passages · 7 sources · 4 named voices
Counterview: recorded · Limitations recorded: 3. Feeds the Medical Affairs question.
Draws on: Population and setting, Design and conduct.
06. Tissue-of-origin treatment remains an explicitly contested alternative
18 statements · 18 passages · 11 sources · 11 named voices
Counterview: recorded · Limitations recorded: 2. Feeds the Medical Affairs question.
Draws on: Population and setting, The comparison.
07. Diagnostic rigor is viewed as both a major strength and a barrier to participation
28 statements · 24 passages · 12 sources · 6 named voices
Counterview: recorded · Limitations recorded: 2. Feeds the Medical Affairs question.
Draws on: Design and conduct.
08. Liquid biopsy addresses a real tissue constraint, with qualified feasibility and access
10 statements · 7 passages · 4 sources · 1 named voices
Counterview: none recorded · Limitations recorded: 2. Feeds the Medical Affairs question.
09. Testing, treatment access and referral must be considered together
13 statements · 9 passages · 9 sources · 6 named voices
Counterview: recorded · Limitations recorded: 3. Feeds the Medical Affairs question.
10. Favorable tolerability language does not mean no harm or no monitoring burden
7 statements · 5 passages · 5 sources · 1 named voices
Counterview: none recorded · Limitations recorded: 2. Feeds the Medical Affairs question.
Draws on: Safety and tolerability, Primary endpoint: Progression Free Survival (PFS) as Assessed by the Investigator According to Response Evaluation Criteria In Solid Tumors v1.1 (RECIST v1.1), Secondary endpoint: Overall Survival (OS).
11. Patient experience gives the findings meaning without establishing cure
38 statements · 37 passages · 25 sources · 20 named voices
Counterview: recorded · Limitations recorded: 2. Feeds the Medical Affairs question.
Draws on: Secondary endpoint: Overall Survival (OS), Secondary endpoint: Duration of Response (DOR), Population and setting, Primary endpoint: Progression Free Survival (PFS) as Assessed by the Investigator According to Response Evaluation Criteria In Solid Tumors v1.1 (RECIST v1.1), Design and conduct.
12. Molecularly informed classification is proposed, with integrated assessment and treatment-specific validation still needed
39 statements · 36 passages · 14 sources · 6 named voices
Counterview: recorded · Limitations recorded: 3. Feeds the Medical Affairs question.
Draws on: The comparison, Design and conduct, Secondary endpoint: Overall Survival (OS), Population and setting.
Counts overlap, since one statement can back several findings. They show what the report kept, not how many clinicians agree. The full report includes the interpretations and source links.
Select a finding to see what the full report holds for it: how many verified HCP statements and of what kind, the passages behind them, the sources and voices, and the counterview and limits it records. Select a part of the trial to see which findings draw on it.
- Finding 1 of 12
A positive PFS result is not an established overall-survival benefit
- statements
- 18
- passages
- 15
- sources
- 10
- named voices
- 5
What the statements areViews 10Questions and uncertainty 3Clinical experience 0Comparisons 0Restated results and context 5How passages are usedSupporting a statement 19Giving context 1Recorded with the finding- Counterview: recorded
- Limitations: 2
- Feeds the Medical Affairs question
- 5 posts and articles
- 4 podcasts and video
- 1 publication
Draws on: Secondary endpoint: Overall Survival (OS), Primary endpoint: Progression Free Survival (PFS) as Assessed by the Investigator According to Response Evaluation Criteria In Solid Tumors v1.1 (RECIST v1.1).
In the full report: the interpretation in full, all 18 statements cited to source and date, and the 10 sources linked where public.
Thicker lines mean more shared statements. A finding without a line goes beyond the registered design. Counts overlap, since one statement can back several findings, and they show what the report kept, not how many clinicians agree.
The full CUPISCO report gives each finding its interpretation, the attributed views behind it, counterviews, limits and the verified HCP statements, each linked to the original. Get a complete report free to see what you get.
How should Medical Affairs communicate the value of early molecularly informed care while making endpoint uncertainty, treatment-specific evidence limits and feasible access explicit?
Raised by the leading finding. The report shows what clinicians said and the sources behind it; it does not settle the question.
By the numbers
free- 116HCP commentary sources screened
- 68sources cited by verified HCP statements
- 32named in screened sources
- 29voices cited in the report
- 20cited voices matched to verified clinician profiles
Also in the sources: 10 organizational or shared accounts, not counted as people.
- 358verified statements, each linked to its source
- 37of them from speakers with a confirmed clinical role
- 12findings
Screened sources were retrieved for this trial. Cited sources back at least one verified statement and include primary sources used for context. No count estimates how many clinicians hold a view. Size (Deep) is set by the 358 verified statements. Statements from sponsors, hosts and organisations are labelled and count apart from identified clinicians. A confirmed clinical role is one verified by the NPI registry or by the person's own institution's staff page; a role a source only states is not counted.
What's inside
free| Section | Items | Access |
|---|---|---|
| Findings with interpretation, counterviews and limits | 12 | Titles free |
| Detailed analysis | 13 sections | Paid |
| Verified statements with short source quotes and links | 358 | Paid |
| Trial aspects mapped | 16 | Free |
| Sources with links | 68 | Counts free |
| Speaker attribution for cited voices | 29 | Paid |
Trial aspects
15 discussed · 1 no commentary · 0 incomplete| Aspect | Statements | Sources |
|---|---|---|
| Primary endpoint: Progression Free Survival (PFS) as Assessed by the Investigator According to Response Evaluation Criteria In Solid Tumors v1.1 (RECIST v1.1) | 28 | 20 |
| Secondary endpoint: Overall Survival (OS) | 16 | 13 |
| Secondary endpoint: Objective Response Rate (ORR) | 2 | 2 |
| Secondary endpoint: Duration of Response (DOR) | 3 | 2 |
| Secondary endpoint: Disease Control Rate (DCR)no commentary found | 0 | 0 |
| Population and setting | 31 | 13 |
| The comparison | 33 | 15 |
| Safety and tolerability | 3 | 3 |
| Design and conduct | 35 | 17 |
| Timing of profiling and limits of the primary-tumor search | 23 | 10 |
| Origin inference, alternative treatment selection and diagnostic harm | 18 | 11 |
| Tissue stewardship and liquid-biopsy feasibility | 9 | 3 |
| Treatment access, guideline adoption and referral | 21 | 13 |
| Patient experience, durable-remission anecdotes and noncurative expectations | 33 | 23 |
| Molecular heterogeneity, proposed classification and next research priorities | 30 | 11 |
| Integrated-care value, benefit magnitude and resource allocation | 31 | 8 |
An aspect marked incomplete is a question the public commentary did not let us answer. We show it rather than hide it.
Sources
free| Channel | Screened | Cited | |
|---|---|---|---|
| X threads | 98 | 46 | |
| YouTube | 12 | 12 | |
| Bluesky threads | 3 | 1 | |
| Podcasts | 2 | 2 | |
| LinkedIn posts | 1 | 1 | |
| Primary sources, cited for context, not screened | |||
| Publications | not screened | 5 | |
| Registry | not screened | 1 | |
max 37 / quarter
- Screened window
- Oct 19, 2018 → Sep 18, 2026
- Cited window
- Oct 19, 2018 → Sep 18, 2026
- Retrieved
- Oct 31, 2026
The trial
from ClinicalTrials.gov- Title
- A Phase II, Randomized, Active-Controlled, Multi-Center Study Comparing the Efficacy and Safety of Targeted Therapy or Cancer Immunotherapy Guided by Genomic Profiling Versus Platinum-Based Chemotherapy in Patients With Cancer of Unknown Primary Site Who Have Received Three Cycles of Platinum Doublet Chemotherapy
- Registry
- NCT03498521
- Study IDs
- MX39795 · 2017-003040-20
- Sponsor
- Hoffmann-La Roche
- Collaborators
- Foundation Medicine
- Design
- Phase 2 · Interventional, randomized, parallel
- Status
- Completed
- Enrollment
- 529 actual
- Registered
- 2018-04-13
- Start
- 2018-07-10 actual
- Primary completion
- 2023-02-14 actual
- Primary endpoint
- Progression Free Survival (PFS) as Assessed by the Investigator According to Response Evaluation Criteria In Solid Tumors v1.1 (RECIST v1.1)
- Interventions
- 18 registered
Scope and limits
freeThis report does not judge efficacy, estimate HCP prevalence or consensus or give treatment advice.
- Discussion that does not name the trial may be missing from this edition.
- Not yet captured in this edition: a question about treatment selection for cancer of unknown primary.
- Not yet captured in this edition: a view on genomic profiling–guided treatment versus platinum chemotherapy in cancer of unknown primary.
- Some passages in the sources used in this report were not fully assessed for clinician views, so a view there may be missing from this edition.
- 92 statements in the sources reviewed for this edition are about other patients or topics, or only mention the trial, and are not counted.
- Further source limits: discussion that describes the trial without naming it may be incomplete; some discussion that describes the trial without naming it may be missing; sources about other trials are not included.
- The sources reviewed for this edition are not a representative sample of all HCP opinion. Reposts, shared presentation accounts and repeated statements do not establish independent agreement.
- Coverage of connected alternative-study discussions remains incomplete in this edition, including CUP-ONE's diagnostic comparison, separate molecular-strategy studies' survival and reclassification findings, and further research uses of GEFCAPI04 data and tissue. Those questions should not be treated as resolved by this report.
- Several podcast and video passages cannot be assigned to a named speaker. Their views remain attributed to the episode or discussion and are not treated as additional distinct clinicians.
- Some speakers' identities or clinical roles are not established in the sources used in this report; each statement is attributed only as far as its source shows.
- Sources describe some contributors as involved in, presenting or reporting CUPISCO. Those descriptions are attributed source context, not independently established trial roles or evidence of external confirmation.
- The material spans recruitment-period expectations, initial-results reactions and updated analyses. Post dates do not establish presentation dates, and differences across sources do not establish that a speaker changed their mind.
- Some oral accounts use unspecified survival terminology or numbers that differ from publications. They are preserved as statements made rather than silently converted into corrected trial results.
- Long remissions, individual survival experiences, retrospective treatment matching and exploratory molecular clusters do not establish comparative efficacy for an individual drug or patient.
- Access and reimbursement accounts are local, dated and sometimes explicitly experiential or unverified. A comprehensive current regulatory assessment was not available.
How reports are built and checked: Methods.
Editions and corrections
freeLast checked for new commentary Oct 31, 2026. A new or changed finding gets a new version number; added evidence alone is a smaller update. No corrections.
Cite this report
Erudio Health. CUPISCO (NCT03498521): HCP commentary report. Edition 1, v1.0.0. Accepted Oct 31, 2026. https://www.erudio.com/reports/cupisco-nct03498521
For your AI agent
Paste this into ChatGPT, Claude, Microsoft Copilot or your own agent. It previews this report through the free Erudio MCP server, tells you whether it answers your question, and orders it if you ask. Some agents ask you to confirm pasted instructions before acting; that is expected.
Help me decide whether to buy the Erudio report "CUPISCO" (NCT03498521), and buy it for me if I ask. Erudio reports cover what clinicians say in public about one clinical trial, with every verified statement linked to its source.
1. Use the free Erudio MCP server at https://mcp.erudio.com/free; it needs no sign-in. Nothing needs installing: if it is not connected in this app and you can make HTTP requests, call it directly with JSON-RPC POSTs to that URL (initialize, then tools/call), sending "Accept: application/json, text/event-stream". Call get_report_card with slug "cupisco-03498521". If you cannot make requests, read https://www.erudio.com/reports/cupisco-nct03498521.md instead.
2. In a few lines, tell me what the report covers: its findings, its verified statements and sources, its evidence window, what it leaves out, and the price of each product (offer). Then ask what I need it for, and say plainly whether this report answers it.
3. If I want it, ask for my work email and the product: the current edition, or 3, 6 or 12 months of weekly updates. Call create_order with report "NCT03498521", that product and email, then show me the quote and the checkout_url to pay by card. If you have a payment client for HTTP 402 payments and I agree, you can pay the pay_url instead. Nothing is charged until one is paid.
4. Once it is paid, call get_order with the status_url: it returns my license key. Then use the Erudio MCP server at https://mcp.erudio.com/mcp with the header "Authorization: Bearer <key>". Call read_report with report_id erudio-nct03498521 and sections ["all"], and summarize the findings for me with their sources. The full report is large (about 500 KB): save the response to a file and work from it rather than printing it. If you cannot, read sections ["narratives"] first, the executive summary and analysis.
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Keep the key private to my organization.Or read the record directly: JSON, Markdown or MCP
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get_report_card({ "slug": "cupisco-03498521" })release 50e8ebef0bdc27df9343580e21a5978ee70a473bf2ab71b4e86717d6896836c2