TY - JOUR
T1 - Impact of the first generation of children⇔s oncology group clinical trials on clinical practice for wilms tumor
AU - Dome, Jeffrey S.
AU - Mullen, Elizabeth A.
AU - Dix, David B.
AU - Gratias, Eric J.
AU - Ehrlich, Peter F.
AU - Daw, Najat C.
AU - Geller, James I.
AU - Chintagumpala, Murali
AU - Khanna, Geetika
AU - Kalapurakal, John A.
AU - Renfro, Lindsay A.
AU - Perlman, Elizabeth J.
AU - Grundy, Paul E.
AU - Fernandez, Conrad V.
N1 - Funding Information:
Children’s Oncology Group studies were sponsored by grants from the NIH (U10CA180886, U10CA180899, U10CA098543, U10-CA098413, and U24CA114766). The authors are indebted to our fellow members of the COG Renal Tumor Committee, the many health professionals who supported the studies, and the parents and children who participated and helped advance the field.
Publisher Copyright:
© 2021 Harborside Press. All rights reserved.
PY - 2021/8
Y1 - 2021/8
N2 - Refinements in surgery, radiation therapy, and chemotherapy since the mid-20th century have resulted in a survival rate exceeding 90% for patients with Wilms tumor (WT). Although this figure is remarkable, a significant proportion of patients continue to have event-free survival (EFS) estimates of,75%, and nearly 25% of survivors experience severe chronic medical conditions. The first-generation Children’s Oncology Group (COG) renal tumor trials (AREN ‘0’), which opened to enrollment in 2006, focused on augmenting treatment regimens for WT subgroups with predicted EFS,75% to 80%, including those with the adverse prognostic marker of combined loss of heterozygosity (LOH) at chromosomes 1p/16q, pulmonary metastasis with incomplete lung nodule response after 6 weeks of chemotherapy, bilateral disease, and anaplastic histology. Conversely, therapy was reduced for patient subgroups with good outcomes and potential for long-term toxicity, such as those with lung metastasis with complete lung nodule response after 6 weeks of chemotherapy. This article summarizes the key findings of the first-generation COG renal tumor studies and their implications for clinical practice.
AB - Refinements in surgery, radiation therapy, and chemotherapy since the mid-20th century have resulted in a survival rate exceeding 90% for patients with Wilms tumor (WT). Although this figure is remarkable, a significant proportion of patients continue to have event-free survival (EFS) estimates of,75%, and nearly 25% of survivors experience severe chronic medical conditions. The first-generation Children’s Oncology Group (COG) renal tumor trials (AREN ‘0’), which opened to enrollment in 2006, focused on augmenting treatment regimens for WT subgroups with predicted EFS,75% to 80%, including those with the adverse prognostic marker of combined loss of heterozygosity (LOH) at chromosomes 1p/16q, pulmonary metastasis with incomplete lung nodule response after 6 weeks of chemotherapy, bilateral disease, and anaplastic histology. Conversely, therapy was reduced for patient subgroups with good outcomes and potential for long-term toxicity, such as those with lung metastasis with complete lung nodule response after 6 weeks of chemotherapy. This article summarizes the key findings of the first-generation COG renal tumor studies and their implications for clinical practice.
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U2 - 10.6004/jnccn.2021.7070
DO - 10.6004/jnccn.2021.7070
M3 - Review article
C2 - 34416705
AN - SCOPUS:85113302025
SN - 1540-1405
VL - 19
SP - 978
EP - 985
JO - JNCCN Journal of the National Comprehensive Cancer Network
JF - JNCCN Journal of the National Comprehensive Cancer Network
IS - 8
ER -