A Phase II Study of New Treatment Approaches for High-Risk Renal Tumors

Kidney (renal) cancers in children and young adults may be treated with surgery, chemotherapy, and/or radiation therapy. Patients with high-risk renal tumors have an increased chance of recurrence after treatment. The purpose of this Children’s Oncology Group study is to evaluate several new approaches to treating children, adolescents, and young adults with different types and stages of renal tumors.

There are multiple treatment arms in this study. Researchers are evaluating:

• Surgery alone for patients with renal cell carcinoma.
• Two therapies for metastatic anaplastic Wilms tumor: A new combination of five drugs (vincristine, cyclophosphamide, doxorubicin, carboplatin, etoposide — an approach called “Revised Regimen UH-1”) or using irinotecan and vincristine before starting Revised Regimen UH-1.
• Revised Regimen UH-1 in patients with stage II-IV anaplastic Wilms tumor, malignant rhabdoid tumor, or stage IV clear cell sarcoma of the kidney.
• Vincristine, dactinomycin, doxorubicin, and radiation therapy (“DD-4A”) for stage I anaplastic Wilms tumor.
• Vincristine, doxorubicin, etoposide, and cyclophosphamide without radiation therapy for patients with stage I clear cell sarcoma of the kidney, to see if patients with stage I disease can be spared from radiation therapy to the abdomen without adversely affecting outcome.