Results of the Childhood Cancer and Leukaemia Group's United Kingdom Relapsed Wilms Tumour Trial.
No Thumbnail Available
All Authors
Vaidya, SJ.
Moroz, V.
Hale, J.
Pavasovic, V.
Hobson, R.
Sartori, P.
Saunders, D.
Powis, M.
Vujanic, GM.
Baker, S.
LTHT Author
Powis, Mark
LTHT Department
Leeds Children's Hospital
Paediatric Surgery
Paediatric Surgery
Non Medic
Publication Date
2026
Item Type
Journal Article
Clinical Trial
Multicenter Study
Language
Subject
CLINICAL TRIALS AS TOPIC , CHEMOTHERAPY , RECURRENCE , KIDNEY NEOPLASMS , PAEDIATRICS , ANTINEOPLASTIC AGENTS , ANTINEOPLASTIC COMBINED CHEMOTHERAPY PROTOCOLS , CHILD
Subject Headings
Abstract
BACKGROUND: The United Kingdom relapsed Wilms tumour (UKW-R) trial aimed to improve the historically low survival rates after relapse of Wilms tumour (WT) through a prospective national risk-stratified protocol. The trial also evaluated efficacy and toxicity of high-dose melphalan.
METHODS: Patients with relapsed/refractory WT were allocated to one of three treatment groups based on time to relapse and initial therapy. Group A: Patients with Stage 1 non-anaplastic WT treated only with vincristine (VCR) or up to two doses of VCR + actinomycin D (ACT) relapsing > 6 months from diagnosis received 'intensive' AVD (ACT + VCR + doxorubicin [DOX]). Group B: Patients with Stage 2 non-anaplastic WT treated with VCR + ACT relapsing > 6 months from diagnosis received eight alternating courses of DOX/cyclophosphamide (CPM) and CPM/etoposide (ETOP). Group C: All other patients whose initial therapy included additional DOX, other drugs and/or radiotherapy received six alternating courses of carboplatin (CARBO)/ETOP and CPM/ETOP followed by melphalan + autologous stem cell rescue (M + ASCT). All patients were recommended radiotherapy +/- surgery for sites of relapse.
RESULTS: From 2002 to 2008, 78 children were enrolled (Group A: 13, Group B: 10 and Group C: 55). Median age was 5.3 years. 38 children received M + ASCT with no transplant related mortality. 25 children died (5: Group A + B and 20: Group C), all from tumour related causes. The 4-year event-free and overall survival for the whole group were 63% and 68%, and 77%/81% (Group A + B) and 57%/63% (Group C), respectively. Median follow-up for alive patients is 65.4 months (8.1-155.4).
DISCUSSION: Survival rates following risk stratification including M + ASCT are higher than historical observations for similar high-risk groups that did not include high-dose chemotherapy.
Journal
Pediatric Blood & Cancer