Faculty Collaboration Database

Treatment of relapsed Wilms tumors: lessons learned. Expert Rev Anticancer Ther 2009 Dec;9(12):1807-15

Date

12/04/2009

Pubmed ID

19954292

DOI

10.1586/era.09.159

Scopus ID

2-s2.0-73349125771 (requires institutional sign-in at Scopus site)   97 Citations

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.

Author List

Spreafico F, Pritchard Jones K, Malogolowkin MH, Bergeron C, Hale J, de Kraker J, Dallorso S, Acha T, de Camargo B, Dome JS, Graf N

MESH terms used to index this publication - Major topics in bold

Antineoplastic Combined Chemotherapy Protocols
Child
Combined Modality Therapy
Drug Resistance, Neoplasm
Humans
Kidney Neoplasms
Neoplasm Recurrence, Local
Prognosis
Wilms Tumor