
Around 1 in 5 people diagnosed with cancer in the UK take part in a clinical trial.
This trial looked at improving treatment for children and young people with a type of kidney cancer called Wilms' tumour. The trial was for children and young people up to and including the age of 18. This trial was supported by Cancer Research UK.
Wilms’ tumour (nephroblastoma) is a type of kidney cancer that affects children. When a baby is growing in the womb, the kidneys develop very early on. Sometimes something goes wrong and some of the cells that should have turned into mature kidney cells don’t. These cells can develop into a Wilms’ tumour. It is a rare cancer that affects about 1 in 10,000 children.
Wilms’ tumours are usually treated with chemotherapy and surgery, and sometimes radiotherapy. But doctors wonder if they may be giving more chemotherapy than is necessary for certain types of Wilms' tumours. This extra treatment may be causing side effects and may not be needed to treat the cancer successfully. The chemotherapy drug is called doxorubicin and it can cause heart problems in the long term.
In this trial, they looked at children with stage 2 or stage 3 cancer who have a medium risk of the cancer coming back after treatment. Doctors looked at the Wilms’ tumour cells under a microscope to decide what risk a child had of the cancer coming back.
The aim of the trial was to find if it is safe to exclude doxorubicin from the usual chemotherapy given to children with Wilms' tumour that has a medium risk of coming back.
The trial team found that doxorubicin doesn’t need to be included in chemotherapy treatment for children and young people with stage 2 or stage 3 cancer who have a medium risk of their Wilms’ tumour coming back.
This was a phase 3 trial. 583 children and young people up to the age of 18 took part. They had stage 2 or stage 3 Wilms' tumour and had already had surgery before joining the trial. The children were put into 1 of 2 groups at random.
The researchers looked at the number of children living 5 years after treatment. They call this overall survival. They found that there was no significant difference between the 2 different groups.
They also looked at whose cancer hadn’t come back at 2 and 5 years. They found this was at 2 Years
And at 5 years
Although the cancer came back in slightly more of the children who didn’t have doxorubicin, the trial team say they all had further treatment that worked well.
The children in the doxorubicin group had more side effects. These included heart problems.
The trial team concluded that it is safe to exclude doxorubicin as part of chemotherapy treatment for this group of children without affecting overall survival.
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists () and published in a medical journal. The figures we quote above were provided by the research team. We have not analysed the data ourselves.
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Professor Kathy Pritchard-Jones
Cancer Research UK
Cancer Research UK Children's Cancer Trials Team
University of Birmingham
NIHR Clinical Research Network: Cancer
This is Cancer Research UK trial number CRUK/02/018.
If you have questions about the trial please contact our cancer information nurses
Freephone 0808 800 4040
Around 1 in 5 people diagnosed with cancer in the UK take part in a clinical trial.