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Grant Details

Grant Number: 2R01CA054498-21A1 Interpret this number
Primary Investigator: Breslow, Norman
Organization: Fred Hutchinson Can Res Ctr
Project Title: Late Effects of Treatment in Wilms Tumor Survivors and Offspring
Fiscal Year: 2012
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Abstract

DESCRIPTION (provided by applicant): This proposal is to study the long term health of children treated for Wilms tumor (WT), and to monitor their offspring for cancer and birth defects. The study is based in the unique and well described cohort of 9,236 patients enrolled during 1969-2002 on one of 5 clinical trials conducted by the National Wilms Tumor Study (NWTS). NWTS studies 3-5 developed treatment protocols that today are administered as "standard therapy" to the vast majority of patients. With this therapy, 90% of children with WT are cured. Survivors, however, are at risk for delayed complications of their disease or its treatment that may compromise their quality of life. Since the disease typically occurs in early childhood, many decades of follow-up are required to appreciate the consequences for adult survivors. Four life-threatening conditions are targeted: secondary malignant neoplasms; congestive heart failure; end stage renal disease (ESRD); and restrictive pulmonary disease. Most occurrences are validated by examination of medical records. Specific goals are to identify new subgroups of patients from NWTS-3-5 at high risk for each condition based on treatment, disease and host factors. Patients at high risk for ESRD, for example, may be considered for renal sparing surgery. Biological samples collected from patients on NWTS-5 will be used to test the hypothesis that mutations in the WT1 gene not only predispose to WT in childhood but also to ESRD in adolescence and adulthood. Systematically collected information on birth weights, congenital anomalies, nephrogenic rests, histologic type, and on radiation and chemotherapy doses will be used to construct risk functions for ESRD and to investigate whether treatment effects on congestive heart failure and secondary malignant neoplasms differ according to the biological subtype of Wilms tumor. The study will estimate rates of ovarian failure in female patients and rates of live birth and risks of pregnancy complications in partners of male patients. Heritability and recurrence risks of WT, together with the frequency of birth defects in the next generation, will be estimated through follow-up of a unique cohort of patient offspring. PUBLIC HEALTH RELEVANCE: By elucidating the late complications of WT and its treatment, and by identifying susceptible subgroups, this study will enable future generations of childhood cancer patients and their physicians to select optimum treatments based on knowledge of long term risks as well as short term benefits. It will assist survivors to make informed decisions regarding the risks of pregnancy and the likelihood that their children will also develop Wilms tumor or birth defects.

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Publications

Radiation therapy for favorable histology Wilms tumor: prevention of flank recurrence did not improve survival on National Wilms Tumor Studies 3 and 4.
Authors: Breslow NE, Beckwith JB, Haase GM, Kalapurakal JA, Ritchey ML, Shamberger RC, Thomas PR, D'Angio GJ, Green DM
Source: Int J Radiat Oncol Biol Phys, 2006 May 1;65(1), p. 203-9.
EPub date: 2006 Mar 20.
PMID: 16542795
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Grant Numbers:
NCI NIH HHS - R01 CA054498-15 NCI NIH HHS - CA54498 NCI NIH HHS - CA42326

MeSH Terms:
Rhabdoid Tumor Neoplasm Staging Humans
Sarcoma, Clear Cell Child Antibiotics, Antineoplastic
Doxorubicin Risk Kidney Neoplasms
Radiotherapy Dosage Wilms Tumor Neoplasm Recurrence, Local
Adolescent Female Male

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Renal failure in the Denys-Drash and Wilms' tumor-aniridia syndromes.
Authors: Breslow NE, Takashima JR, Ritchey ML, Strong LC, Green DM
Source: Cancer Res, 2000 Aug 1;60(15), p. 4030-2.
PMID: 10945603
Related Citations

Grant Numbers:
NCI NIH HHS - CA54498 NCI NIH HHS - CA42326

MeSH Terms:
Glomerulosclerosis, Focal Segmental Renal Insufficiency Humans
Genitalia, Male WAGR Syndrome Child
Child, Preschool Infant Syndrome
Risk Factors Adult Follow-Up Studies
Adolescent Disorders of Sex Development Female
Male Nephrotic Syndrome

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Factors affecting the risk of contralateral Wilms tumor development: a report from the National Wilms Tumor Study Group.
Authors: Coppes MJ, Arnold M, Beckwith JB, Ritchey ML, D'Angio GJ, Green DM, Breslow NE
Source: Cancer, 1999 Apr 1;85(7), p. 1616-25.
PMID: 10193955
Related Citations

Grant Numbers:
NCI NIH HHS - CA54498 NCI NIH HHS - CA42326

MeSH Terms:
Infant Age Factors Neoplasms, Second Primary
Kidney Neoplasms Humans Kidney
Case-Control Studies Wilms Tumor Child
Time Factors Male Female

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Familial Wilms' tumor: a descriptive study.
Authors: Breslow NE, Olson J, Moksness J, Beckwith JB, Grundy P
Source: Med Pediatr Oncol, 1996 Nov;27(5), p. 398-403.
PMID: 8827065
Related Citations

Grant Numbers:
NCI NIH HHS - UIO CA 42326 NCI NIH HHS - R01 CA54498 NCI NIH HHS - P30 CA 16056

MeSH Terms:
Age Factors Neoplasm Staging Humans
Child Age Distribution Child, Preschool
Genomic Imprinting Registries Infant
X Chromosome Survival Rate Kidney Neoplasms
Genes, Wilms Tumor Y Chromosome Adult
Treatment Outcome Wilms Tumor Follow-Up Studies
Adolescent Male Female

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Non-11p constitutional chromosome abnormalities in Wilms' tumor patients.
Authors: Olson JM, Hamilton A, Breslow NE
Source: Med Pediatr Oncol, 1995 May;24(5), p. 305-9.
PMID: 7700182
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Grant Numbers:
NCI NIH HHS - 1-R01-CA54498 NCI NIH HHS - 5-T32-CA09168-17

MeSH Terms:
Chromosomes, Human, Pair 18 Humans Child
Trisomy Child, Preschool Chromosomes, Human, Pair 11
Turner Syndrome Infant Kidney Neoplasms
Chromosome Aberrations Wilms Tumor Adolescent
Female Male

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Increased birth weights of National Wilms' Tumor Study patients suggest a growth factor excess.
Authors: Leisenring WM, Breslow NE, Evans IE, Beckwith JB, Coppes MJ, Grundy P
Source: Cancer Res, 1994 Sep 1;54(17), p. 4680-3.
PMID: 8062264
Related Citations

Grant Numbers:
NCI NIH HHS - R01 CA54498 NCI NIH HHS - U01 CA42326

MeSH Terms:
Birth Weight Hypertrophy Kidney Neoplasms
Humans Kidney Wilms Tumor
Beckwith-Wiedemann Syndrome

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Cancer in twins of Wilms tumor patients.
Authors: Olson JM, Breslow NE, Barce J
Source: Am J Med Genet, 1993 Aug 1;47(1), p. 91-4.
PMID: 8396323
Related Citations

Grant Numbers:
NCI NIH HHS - 1-R01-CA54498 NCI NIH HHS - 5-T32-CA09168-17

MeSH Terms:
United States Humans Diseases in Twins
Poisson Distribution Twins, Dizygotic Beckwith-Wiedemann Syndrome
Child, Preschool Infant Hypospadias
Twins, Monozygotic Kidney Neoplasms Risk Factors
Kidney Medulloblastoma Wilms Tumor
Female Male

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Wilms' tumour and parental age: a report from the National Wilms' Tumour Study.
Authors: Olson JM, Breslow NE, Beckwith JB
Source: Br J Cancer, 1993 Apr;67(4), p. 813-8.
PMID: 8385980
Related Citations

Grant Numbers:
NCI NIH HHS - 1-R01-CA54498 NCI NIH HHS - 5-T32-CA09168-17

MeSH Terms:
Paternal Age Maternal Age Humans
Cohort Studies Adult Wilms Tumor
Mutation Male Female

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Epidemiology of Wilms tumor.
Authors: Breslow N, Olshan A, Beckwith JB, Green DM
Source: Med Pediatr Oncol, 1993;21(3), p. 172-81.
PMID: 7680412
Related Citations

Grant Numbers:
NCI NIH HHS - 7 U10 CA42326-07 NCI NIH HHS - R01 CA54498-01

MeSH Terms:
Age Factors Americas Humans
Child Europe Child, Preschool
Infant Kidney Neoplasms Risk Factors
Environmental Exposure Wilms Tumor Africa
Incidence Asia Male
Female

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