Advances in the clinical management of high-risk Wilms tumors
- PMID: 36625399
- DOI: 10.1002/pbc.30153
Advances in the clinical management of high-risk Wilms tumors
Abstract
Outcomes are excellent for the majority of patients with Wilms tumors (WT). However, there remain WT subgroups for which the survival rate is approximately 50% or lower. Acknowledging that the composition of this high-risk group has changed over time reflecting improvements in therapy, we introduce the authors' view of the historical and current approach to the classification and treatment of high-risk WT. For this review, we consider high-risk WT to include patients with newly diagnosed metastatic blastemal-type or diffuse anaplastic histology, those who relapse after having been initially treated with three or more different chemotherapeutics, or those who relapse more than once. In certain low- or low middle-income settings, socio-economic factors expand the definition of what constitutes a high-risk WT. As conventional therapies are inadequate to cure the majority of high-risk WT patients, advancement of laboratory and early-phase clinical investigations to identify active agents is urgently needed.
Keywords: COG; SIOP; Wilms tumor; high risk; nephroblastoma; relapsed.
© 2023 Wiley Periodicals LLC.
References
REFERENCES
-
- Dome JS, Graf N, Geller JI, et al. Advances in Wilms tumor treatment and biology: progress through international collaboration. J Clin Oncol. 2015;33(27):2999-3007. https://doi.org/10.1200/jco.2015.62.1888
-
- Dome JS, Mullen EA, Dix DB, et al. Impact of the first generation of Children's Oncology Group clinical trials on clinical practice for Wilms tumor. J Natl Compr Canc Netw. 2021;19(8):978-985. https://doi.org/10.6004/jnccn.2021.7070
-
- Green DM, Beckwith JB, Breslow NE, et al. Treatment of children with stages II to IV anaplastic Wilms' tumor: a report from the National Wilms' Tumor Study Group. J Clin Oncol. 1994;12(10):2126-2131.
-
- Daw NC, Chi YY, Kalapurakal JA, et al. Activity of vincristine and irinotecan in diffuse anaplastic Wilms tumor and therapy outcomes of stage II to IV disease: results of the Children's Oncology Group AREN0321 study. J Clin Oncol. 2020;38(14):1558-1568. https://doi.org/10.1200/JCO.19.01265
-
- Grundy PE, Breslow NE, Li S, et al. Loss of heterozygosity for chromosomes 1p and 16q is an adverse prognostic factor in favorable-histology Wilms tumor: a report from the National Wilms Tumor Study Group. J Clin Oncol. 2005;23(29):7312-7321. https://doi.org/10.1200/JCO.2005.01.2799
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Medical