Conrad V. Fernandez, MD
In patients with stage III favorable-histology Wilms tumor, negative nodal involvement and the absence of loss of heterozygosity (LOH) at chromosomes 1p and 16q were predictors for event-free survival (EFS) and overall survival (OS), according to results from the COG AREN0532 study.
“Given the serious potential late effects of doxorubicin, we believe it essential to examine strategies to eliminate anthracyclines in patients with an excellent prognosis. At the same time, prevention of relapse in higher risk patients is an important goal,” Fernandez wrote. “Taken together, the COG Renal Tumors Committee is strongly considering using a prognostic algorithm of upfront nephrectomy when feasible, incorporating LOH 1p/16q status and 1q gain to identify patients who merit more intensive therapy. We are also planning to study the omission of doxorubicin in patients who lack these risk factors.”
Fernandez CV, Mullen EA, Chi YY, et al. Outcome and prognostic factors in stage III favorable-histology Wilms tumor: A report from the Children’s Oncology Group study AREN0532 [published online December 6, 2017]. J Clin Oncol doi: 10.1200/JCO.2017. 73.7999.
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