Treatment of relapsed Wilms tumors: Lessons learned

Filippo Spreafico, Kathy Pritchard Jones, Marcio H. Malogolowkin, Christophe Bergeron, Juliet Hale, Jan De Kraker, Sandro Dallorso, Thomás Acha, Beatriz De Camargo, Jeffrey S. Dome, Norbert Graf

Research output: Contribution to journalArticle

Abstract

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 for recurrent disease. While intense-dose chemotherapy is uniformly accepted to treat high-risk recurrent WTs, the optimal therapy for standard-risk children has yet to be defined, owing to the small number of such patients and their relatively better prognosis compared with high-risk recurrences. Recurrent tumors among those defined as very-high risk are likely to develop chemoresistant disease, and novel therapeutic strategies will be necessary to cure these patients. Evidence on how to properly administer surgery and radiotherapy at relapse is more fragmentary. The authors have reviewed the available experiences concerning the treatment of recurrent WT, and have attempted to provide the most up-to-date recommendations regarding the optimal risk-based treatment for these patients.

Original languageEnglish
Pages (from-to)1807-1815
Number of pages9
JournalExpert Review of Anticancer Therapy
Volume9
Issue number12
DOIs
Publication statusPublished - Dec 2009

Keywords

  • Chemotherapy
  • Pediatric renal tumor
  • Relapse
  • Wilms tumor

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Oncology

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  • Cite this

    Spreafico, F., Jones, K. P., Malogolowkin, M. H., Bergeron, C., Hale, J., De Kraker, J., Dallorso, S., Acha, T., De Camargo, B., Dome, J. S., & Graf, N. (2009). Treatment of relapsed Wilms tumors: Lessons learned. Expert Review of Anticancer Therapy, 9(12), 1807-1815. https://doi.org/10.1586/ERA.09.159