Login / Signup

Advances in the clinical management of high-risk Wilms tumors.

Michael V OrtizChrista KoenigAmy E ArmstrongJesper BrokBeatriz de CamargoAnnelies M C Mavinkurve-GroothuisThelma B Velasquez HerreraRajkumar VenkatramaniAndrew D WoodsJeffrey S DomeFilippo Spreafico
Published in: Pediatric blood & cancer (2023)
Outcomes are excellent for the majority of patients with Wilms tumors (WT). However, there remain WT subgroups for which the survival rate is approximately 50% or lower. Acknowledging that the composition of this high-risk group has changed over time reflecting improvements in therapy, we introduce the authors' view of the historical and current approach to the classification and treatment of high-risk WT. For this review, we consider high-risk WT to include patients with newly diagnosed metastatic blastemal-type or diffuse anaplastic histology, those who relapse after having been initially treated with three or more different chemotherapeutics, or those who relapse more than once. In certain low- or low middle-income settings, socio-economic factors expand the definition of what constitutes a high-risk WT. As conventional therapies are inadequate to cure the majority of high-risk WT patients, advancement of laboratory and early-phase clinical investigations to identify active agents is urgently needed.
Keyphrases
  • newly diagnosed
  • squamous cell carcinoma
  • machine learning
  • mental health
  • deep learning
  • free survival
  • type diabetes
  • mesenchymal stem cells
  • metabolic syndrome
  • adipose tissue
  • skeletal muscle
  • combination therapy