New approaches to risk stratification for Wilms tumor

Nelson MV, van den Heuvel-Eibrink MM, Graf N, Dome JS. New approaches to risk stratification for Wilms tumor. Curr Opin Pediatr. 2021 Feb 1;33(1):40-48. doi: 10.1097/MOP.0000000000000988. Epub 2020 Dec 29. Review. PubMed PMID: 33394739; PubMed Central PMCID: PMC7919941.

The treatment of Wilms tumor (WT) is one of the great achievements in the field of oncology. One of the key success factors has been improved risk stratification, enabling augmentation or reduction of therapy depending on a patienťs risk of relapse. This article highlights the evolution of clinical and biological prognostic markers that have been applied in the treatment of WT. Historically, tumor stage and histology were the sole determinants of WT treatment. Recent clinical trials conducted by the Children’s Oncology Group (COG) and the International Society of Pediatric Oncology (SIOP) Renal Tumor Study Group have expanded the menu of prognostic factors to include histologic and volumetric response to therapy and tumor-specific loss of heterozygosity (LOH) at chromosomes 1p and 16q. Augmentation of therapy has been able to overcome the adverse risk factors. An emerging prognostic marker is chromosome 1q gain, will be incorporated into future clinical trials.