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OUTCOMES OF RELAPSED FAVORABLE HISTOLOGY WILMS TUMOR IN NON-CLINICAL TRIAL SETTING
  • +7
  • Netta Schneller,
  • Najat Daw,
  • Whitney Throckmorton,
  • Elizabeth Mullen,
  • Kylene DeSmith,
  • Leo Mascarenhas,
  • Cameron O’Connell,
  • Conrad Fernandez,
  • Kathryn Sutton,
  • Rajkumar Venkatramani
Netta Schneller
Texas Children's Cancer Center and Hematology Centers

Corresponding Author:netta.schneller@bcm.edu

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Najat Daw
The University of Texas MD Anderson Cancer Center Children's Cancer Hospital
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Whitney Throckmorton
The University of Texas MD Anderson Cancer Center Children's Cancer Hospital
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Elizabeth Mullen
Dana-Farber Cancer Institute Department of Pediatric Oncology
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Kylene DeSmith
Dana-Farber Cancer Institute Department of Pediatric Oncology
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Leo Mascarenhas
Children's Hospital Los Angeles
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Cameron O’Connell
Children's Hospital Los Angeles
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Conrad Fernandez
Dalhousie University Department of Pediatrics
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Kathryn Sutton
Children's Healthcare of Atlanta Inc Aflac Cancer and Blood Disorders Center
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Rajkumar Venkatramani
Texas Children's Cancer Center and Hematology Centers
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Abstract

Background The last major North American cooperative group clinical trial for relapsed favorable histology Wilms tumor (FHWT) was completed in 2002. The outcomes of patients with relapsed Wilms tumor subsequently treated outside of clinical trials is unknown. The aim of this study was to assess the efficacy and toxicity of salvage therapies used for patients with FHWT suffering first relapse. Methods We conducted a retrospective chart review of patients treated for first relapse of FHWT at six large North American institutions from January 2002 through August 2018. Results Ninety-four patients were identified. Thirty-six patients were classified as standard-risk relapse (SRR), 49 patients as high-risk relapse (HRR) and seven patients as very high-risk relapse (VHRR). Twenty-one patients with SRR were treated with Regimen I. The 4-year EFS and OS for SRR was 82.4% and 93.3%, respectively, with median follow up of 72 months. Twenty-eight HRR/VHRR patients were treated with ICE therapy while 13 received NWTS5 Stratum C. No patient completed protocol therapy per stratum C; median maintenance cycles administered was 2. The 4-year EFS and OS for HRR/VHRR was 32.6% and 58.3%, respectively, with median follow up of 33 months. Conclusions Outcomes for all strata of relapsed WT patients treated in a non-clinical setting appear to have similar outcomes as historical cohorts treated on NWTS5. Improved strategies are urgently needed for HRR and VHRR relapses.
27 Mar 2024Submitted to Pediatric Blood & Cancer
27 Mar 2024Submission Checks Completed
27 Mar 2024Assigned to Editor
27 Mar 2024Review(s) Completed, Editorial Evaluation Pending
13 Jul 2024Submission Checks Completed
13 Jul 2024Assigned to Editor
13 Jul 20241st Revision Received
15 Jul 2024Review(s) Completed, Editorial Evaluation Pending
19 Jul 2024Reviewer(s) Assigned
08 Aug 2024Editorial Decision: Revise Minor
05 Sep 2024Submission Checks Completed
05 Sep 2024Assigned to Editor
05 Sep 20242nd Revision Received
05 Sep 2024Review(s) Completed, Editorial Evaluation Pending
06 Sep 2024Editorial Decision: Accept