Treatment of relapsed Wilms tumors: lessons learned

  title={Treatment of relapsed Wilms tumors: lessons learned},
  author={Filippo Spreafico and Kathy Pritchard Jones and Marcio H. Malogolowkin and Christophe Bergeron and Juliet P. Hale and Jan de Kraker and Sandro Dallorso and Thom{\'a}s Acha and Beatriz de Camargo and Jeffrey S. Dome and Norbert Graf},
  journal={Expert Review of Anticancer Therapy},
  pages={1807 - 1815}
Treatment regimens for recurrent Wilms tumor (WT) are currently designed to include drugs that are not used during primary chemotherapy, using a risk-stratified approach. Therapy of recurrent disease depends on the nature of initial treatment, and of recognized prognostic indicators inherent in the primary tumor. Several highly effective chemotherapy regimens, including ifosfamide–carboplatin–etoposide, cyclophosphamide–etoposide and carboplatin–etoposide, are considered first treatment choice… 

Pharmacotherapeutic Management of Wilms Tumor: An Update

Molecular profiling studies are in progress that should ultimately improve both risk classification and signposting to more targeted therapies for the small group for whom current therapies fail, and better in vitro model systems to test mechanistic dependence are needed.

High dose therapy for recurrent Wilms' tumor.

  • T. McLean
  • Medicine
    Translational pediatrics
  • 2014
A review by T.C. Ha and colleagues of the published cases suggests HDT may be beneficial to the very high risk subset of patients with recurrent WT, but this conclusion is fraught with the caveats of any retrospective review.

Pediatric genitourinary tumors

The prognosis for patients with pediatric genitourinary tumors is favorable and further understanding of the biology in these tumors is helping to determine risk stratification, treatment strategies, and candidates for new drug development.

Favorable Response of Heavily Treated Wilms’ Tumor to Paclitaxel and Carboplatin

In a refractory case after intensive treatments, a 17-year-old man presented with hematuria who received combination chemotherapy with carboplatin and paclitaxel succeeded to control the disease for a while.

Advances in Wilms Tumor Treatment and Biology: Progress Through International Collaboration.

An overview of the Children's oncology Group and International Society of Pediatric Oncology approaches to WT focuses on four subgroups (stage IV, initially inoperable, bilateral, and relapsed WT) for which international collaboration is pressing and biologic insights resulting from collaborative laboratory research are discussed.

Wilms Tumor-Nephroblastoma

Nephroblastoma, or Wilms tumor (WT), is the second most common extracranial solid tumor and the most common malignant renal tumor in children, accounting for 5% of all malignancies and 80% of all

Prognostic Factors for Wilms Tumor Recurrence: A Review of the Literature

Improved first-line treatment regimens based on clinicopathological characteristics and advancing knowledge on copy number variations unveil the importance of further investigating the significance of biological markers for WT recurrence in international collaborations.

Current treatment for Wilms tumor: COG and SIOP standards

Current standards of diagnosis and treatment of WT around the world are presented and surgeons must be more focusing on how to maximize preoperative and postoperative treatment possibilities for achieving optimal results of patients with WT.



The management of relapsed Wilms tumor.

Ifosfamide, carboplatin and etoposide in children with poor-risk relapsed Wilms' tumor: a Children's Cancer Group report.

The response rate in children with relapsed and poor-risk Wilms' tumor is >80% with ICE re-induction chemotherapy followed by post-ice therapy, and the optimal approach for post-ICE consolidation therapy has yet to be determined.

High-dose chemotherapy with autologous stem cell rescue in children with nephroblastoma

About half of the children suffering from Wilms tumor with very unfavorable prognostic factors survive disease-free after HDC for over 3 years, and besides hematological toxicity, mucositis and infections, renal function is at risk during HDC.

Response rates in relapsed wilms' tumor. A need for new effective agents

  • C. R. PinkertonJ. J. Groot‐LoonenP. H. Morris‐JonesJ. Pritchard
  • Medicine
  • 1991
The authors conclude that, even for patients with localized disease with favorable histologic findings, the “salvage” rate is little more than 50%, and for all other stages and Histologic findings the likelihood of cure after relapse is remote.

Value and difficulties of a common European strategy for recurrent Wilms’ tumor

The goal of future studies will be to reduce the total burden of therapy and potential for late toxicities while maintaining or improving the current excellent survival rates, through improved risk stratification, to reduce chemotherapy in low-risk children and to intensify treatment for the relatively small subset of children at high risk of relapse.

Treatment of relapsed Wilms' tumor with high-dose therapy and autologous hematopoietic stem-cell rescue: the experience at Children's Memorial Hospital.

  • A. CampbellS. Cohn M. Kletzel
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2004
The results suggest that HDT with HSCR is an effective treatment for patients with Wilms' tumor who experience relapse.

Etoposide in relapsed or refractory Wilms' tumor: a phase II study by the French Society of Pediatric Oncology and the United Kingdom Children's Cancer Study Group.

It is concluded that etoposide in this schedule is an active agent in Wilms' tumor and should be considered for inclusion in regimens for high-risk patients, such as those with metastatic disease at diagnosis and those who relapse after multiagent chemotherapy.

Optimal duration of preoperative therapy in unilateral and nonmetastatic Wilms' tumor in children older than 6 months: results of the Ninth International Society of Pediatric Oncology Wilms' Tumor Trial and Study.

The 4-week schedule pre-nephrectomy chemotherapy regimen should be considered the standard treatment and should continue to improve the cure rate of high-risk patients and the quality of life of children with a more favorable prognosis.

Treatment of anaplastic histology Wilms' tumor: results from the fifth National Wilms' Tumor Study.

  • J. DomeC. Cotton D. Green
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2006
The prognosis for patients with stage I AH is worse than that for patientsWith stage I FH, especially those with stage III to V disease, and novel treatment strategies are needed to improve outcomes.