Treatment of Newly Diagnosed Higher Risk Favorable Histology Wilms Tumors

Surgery, chemotherapy, and/or radiation therapy are routinely used to treat Wilms tumor (a kidney cancer that most commonly occurs in children). However, some treatments can cause side effects later in life. Doctors are therefore seeking effective treatment regimens that have a lower risk of late effects.

In this Children’s Oncology Group study, researchers are determining the best way to treat patients with different types of higher-risk Wilms tumors which had a favorable histology at the time of diagnosis. The goals of the study are to find out:

• If patients whose tumors spread only to their lungs can avoid radiation therapy to the lungs if the tumors disappear after six weeks of standard chemotherapy
• If patients with tumor spread in the lungs that did not go away after six weeks of chemotherapy can be treated with two additional chemotherapy drugs, plus radiation therapy to the lungs
• If patients whose Wilms tumors spread to other parts of the body can be treated with two additional chemotherapy drugs along with the standard drugs and standard radiation therapy
• If information about missing genetic material (called “loss of heterogeneity”) can be used to determine a patient’s treatment.