Guest Column - CureSearch for Children's Cancer: Update on Wilms Tumor Research

CureSearch for Children’s Cancer
Statement of Research Funding Activity
December, 2010

Wilms Tumor

CureSearch for Children’s Cancer, in collaboration with members of the Wilms Tumor community, has raised more than $350,000 in the last three years to fund Wilms Tumor research.  Wilms Tumor is a type of cancer found in the kidneys and is diagnosed in approximately 500 children each year. 

Over the last two years, at the request of the COG leadership, including the COG Chair and the Chair of the Wilms Tumor Disease Committee, Jeffrey Dome, MD, CureSearch funded several projects related to Wilms Tumor.

In determining how to best use funds raised for Wilms Tumor research, Dr. Dome of Children’s National Medical Center in Washington, DC said “we are cautious about using small amounts of money which will not yield significant results.  Instead, we wait until there are substantial dollars accumulated to fund statistically meaningful clinical trials and activities while using small grants from outside foundations to fund basic science which in turn leads to clinical trials.”

Below is a list of the Wilms Tumor projects funded by CureSearch:

Validation of Prognostic Markers for Very Low Risk Tumors
Previous studies of gene expression within Favorable Histology Wilms Tumor have detected two subsets of tumors within Very Low Risk Wilms Tumors (VLRWT) that have higher and lower risks for relapse.  The current study, conducted by Elizabeth Perlman, MD of Children’s Memorial Hospital in Chicago, IL seeks to validate markers of these subsets in order to enable improved therapeutic stratification of VLRWT in future studies, and to investigate the feasibility of broadening the definition of VLRWT.

Dr. Perlman agreed with Dr. Dome saying “without COG research and funding from CureSearch for Children’s Cancer, basic science findings may be just that, findings.  Larger dollar grants are necessary to turn basic science findings into clinical trials because of the need to perform rigorous validation studies.”  Dr. Perlman recently completed the validation of WT1 mutation and 11p15 methylation abnormalities as predictors of relapse in Very Low Risk Tumors not treated with chemotherapy.  These findings will soon be published in the Journal of Clinical Oncology.   In addition she has completed the analysis of 11p15 methylation changes in a large group of all favorable histology Wilms tumor.  These findings show that tumors in patients less than two years of age show a different pattern of 11p15 methylation abnormalities, supporting the biologic relevance of this marker. 

These studies provide evidence to suggest that the current criteria for “Very Low Risk” may be broadened so that fewer children suffer the effects of chemotherapy without impacting on survival.  Finally, the ultimate test of whether these markers can be used to stratify patients in the next protocol will be testing them in patients enrolling in the current protocols.  These studies are in progress.

Wilms Tumor Reference Laboratory
Developing treatments that are risk-based requires complex laboratory testing.  At the Wilms Reference Laboratory at Nationwide Children’s Hospital in Columbus, Ohio, several important functions occur under the direction of Julie M. Gastier-Foster, Ph.D including loss of heterozygosity (LOH) testing, pathology review of the portion of the tumor used for analysis and banking and tracking of residual tissue, and peripheral blood specimens and their associated nucleic acids.

Live Update on Wilms Tumor
Hosted by Dr. Dome, this audio seminar lasted 1.5 hours and provided parents and families both an update about recent research and treatment advances for patients with this cancer and the opportunity to ask questions about these and other topics related to Wilms Tumor.

Collaboration of Experts on Wilms Tumor
A national group of research experts on Wilms Tumor convened in Maryland for several days to discuss recent research findings, current studies and develop a research agenda for the coming years.

Dr. Dome supports the use of CureSearch’s restricted funds for these projects saying “if we spend money in $10,000 increments, the results coming from this work would not be possible.”  He went on to say that he is “pleased with the great partnership with CureSearch for Children’s Cancer and its new leadership.  The team has been incredibly responsive to the Wilms Tumor research funding needs.”  Currently, Dr. Dome is working with COG leadership and CureSearch to determine the next funding initiative in Wilms Tumor research. 

CureSearch for Children’s Cancer continues to be grateful for the continued support of our donors and volunteers who are raising money on behalf of all those affected by Wilms Tumor.

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