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Phase III Randomized Comparison of Short- vs Long-Term Maintenance Chemotherapy in Children with Stages III-IV Favorable Histology Wilms' Tumor and Clear Cell Sarcoma and Comparison of DACT/VCR/DOX vs DACT/VCR/DOX/CTX in Patients with Stages II-IV Anaplastic Wilms' Tumor

Basic Trial Information
Objectives
Entry Criteria
Expected Enrollment
Outline
Published Results
Related Publications
Trial Contact Information

Basic Trial Information

PhaseTypeStatusAgeSponsorProtocol IDs
Phase IIITreatmentClosed16 years and underNCINWTS-4
CCG-461, POG-8650, INT-0070

Objectives

I.  Compare, in a randomized Phase III setting, relapse-free survival and 
overall survival of patients with Stages I and II favorable histology and 
Stage I anaplastic Wilms' tumor treated with conventional vs. pulse-intensive 
chemotherapy consisting of vincristine/dactinomycin (randomization closed as 
of 3/1/94).

II.  Compare relapse-free survival and overall survival of patients with 
Stages III and IV favorable histology Wilms' tumor and Stages I-IV clear cell 
sarcoma of the kidney randomized to treatment with conventional vs. 
pulse-intensive chemotherapy consisting of 
vincristine/dactinomycin/doxorubicin, both regimens combined with radiotherapy.

III.  Compare relapse-free survival and overall survival of patients with 
Stages II-IV anaplastic Wilms' tumor randomized to treatment with 
vincristine/dactinomycin/doxorubicin vs. the same three agents plus 
cyclophosphamide, both regimens combined with radiotherapy (randomization 
closed as of 11/19/93).

IV.  Compare the relapse-free survival and overall survival of patients with 
Stages II-IV favorable histology Wilms' tumor and Stages I-IV clear cell 
sarcoma of the kidney treated for approximately 6 vs. approximately 15 months 
following nephrectomy.

Entry Criteria

Disease Characteristics:


Wilms' tumor of favorable or anaplastic histology, including
clear cell sarcoma of the kidney

For patients to be randomized:
  Stage III/IV favorable histology
  Stage I-IV clear cell sarcoma of the kidney
           AND
  No prior chemotherapy or radiotherapy
  Prior nephrectomy required
           AND
  Age less than 16

For patients to be followed but not randomized:
  Stage I-IV favorable histology
  Stage I-IV anaplastic histology
  Stage I-IV clear cell sarcoma of the kidney
  Stage I-IV malignant rhabdoid tumor of the kidney
           AND
  Medical or social condition prevents randomization, e.g.:
     Parent refuses randomization
     Chemotherapy was initiated prior to randomization
     Medical contraindication to administration of a particular
        regimen
     Institution excludes all patients of a certain stage or
        age from randomization
     Pulmonary metastases were diagnosed only on chest CT with
        negative chest film
     Bilateral (Stage V) tumor is present
     Tumor occurs in fused (horseshoe or discoid) kidneys
     Extrarenal Wilms' tumor is present
     Tumor is too large to be removed prior to chemotherapy or
        radiotherapy
     Age is over 16 at diagnosis

Patients ineligible for either randomization or the "followed"
portion of the study may be registered only, provided one of
the following apply:
  Final pathologic diagnosis is mesoblastic nephroma
  Patient was referred after initiating other therapy
  Patient is being treated on another local protocol
  Patient died during postoperative period


Patient Characteristics:

See General Eligibility Criteria

General Eligibility Criteria:

As of August 10, 1994, entry is 
completely closed to patients
from the Pediatric Oncology Group (POG).  Patients from primary
and affiliate institution members of the Children's Cancer
Study Group (CCG) are eligible for registration only provided they meet any of 
the following criteria:
  Stage I-IV Wilms' tumor of favorable or anaplastic histology
  Stage I-IV clear cell sarcoma of the kidney
  Stage I-IV malignant rhabdoid kidney tumor
  Bilateral (Stage V) tumor
  Tumors in fused (horseshoe or discoid) kidneys
  Extrarenal Wilms's tumor
  Large tumor unsuitable for resection prior to radiotherapy
     and/or chemotherapy

--Disease Characteristics--

Wilms' tumor of favorable or anaplastic histology, including
clear cell sarcoma of the kidney

For patients to be randomized:
  Stage III/IV favorable histology
  Stage I-IV clear cell sarcoma of the kidney
           AND
  No prior chemotherapy or radiotherapy
  Prior nephrectomy required
           AND
  Age less than 16

For patients to be followed but not randomized:
  Stage I-IV favorable histology
  Stage I-IV anaplastic histology
  Stage I-IV clear cell sarcoma of the kidney
  Stage I-IV malignant rhabdoid tumor of the kidney
           AND
  Medical or social condition prevents randomization, e.g.:
     Parent refuses randomization
     Chemotherapy was initiated prior to randomization
     Medical contraindication to administration of a particular
        regimen
     Institution excludes all patients of a certain stage or
        age from randomization
     Pulmonary metastases were diagnosed only on chest CT with
        negative chest film
     Bilateral (Stage V) tumor is present
     Tumor occurs in fused (horseshoe or discoid) kidneys
     Extrarenal Wilms' tumor is present
     Tumor is too large to be removed prior to chemotherapy or
        radiotherapy
     Age is over 16 at diagnosis

Patients ineligible for either randomization or the "followed"
portion of the study may be registered only, provided one of
the following apply:
  Final pathologic diagnosis is mesoblastic nephroma
  Patient was referred after initiating other therapy
  Patient is being treated on another local protocol
  Patient died during postoperative period


Expected Enrollment

About 870 patients will be entered over approximately 7.4 years.

Outline

Patients with Stage III/IV favorable histology and those with Stages I-IV 
clear cell tumors are randomized on Arms V and VI.  A second randomization is 
carried out 5 months after nephrectomy to determine whether patients with 
Stages II-IV favorable histology tumors or Stages I-IV clear cell sarcomas 
receive extended or standard maintenance chemotherapy.  Prior to 2/28/94, 
patients with Stage I favorable or anaplastic histology were randomized on 
Arms I and II, while those with Stage II favorable histology were randomized 
on Arms III and IV.  Prior to 12/93, patients with Stages II-IV anaplastic 
histology were randomized to Arms V and VII.

Arm I:  2-Drug Combination Chemotherapy.  Dactinomycin, DACT, NSC-3053; 
Vincristine, VCR, NSC-67574.  Standard regimen for Stage I.  No randomization 
for extended maintenance chemotherapy.

Arm II:  2-Drug Combination Chemotherapy.  DACT; VCR.  Intensive regimen for 
Stage I.  No randomization for extended maintenance chemotherapy.

Arm III:  2-Drug Combination Chemotherapy.  DACT; VCR.  Standard regimen for 
Stage II favorable histology.  Second randomization for extended maintenance 
chemotherapy.

Arm IV:  2-Drug Combination Chemotherapy.  DACT; VCR.  Intensive regimen for 
Stage II favorable histology.  Second randomization for extended maintenance 
chemotherapy.

Arm V:  3-Drug Combination Chemotherapy plus Radiotherapy. DACT; VCR; 
Doxorubicin, DOX, NSC-123127; plus irradiation of tumor bed and areas of 
metastatic disease using accelerator beams with nominal energies of 4-6 M.  
Standard regimen for Stages III/IV favorable histology, Stages I-IV clear cell 
sarcoma, and Stages II-IV anaplastic tumors.  Second randomization for 
extended maintenance chemotherapy for favorable histology and clear cell 
sarcomas only.

Arm VI:  3-Drug Combination Chemotherapy plus Radiotherapy.  DACT; VCR; DOX; 
plus irradiation as in Arm V.  Intensive regimen for Stages III/IV favorable 
histology and Stages I-IV clear cell sarcoma.  Second randomization for 
extended maintenance chemotherapy.

Arm VII:  4-Drug Combination Chemotherapy plus Radiotherapy.  DACT; VCR; DOX; 
Cyclophosphamide, CTX, NSC-26271; plus irradiation as in Arm V.  Intensive 
regimen for Stage II-IV anaplastic tumors.

Published Results

Hamilton TE, Ritchey ML, Haase GM, et al.: The management of synchronous bilateral Wilms tumor: a report from the National Wilms Tumor Study Group. Ann Surg 253 (5): 1004-10, 2011.[PUBMED Abstract]

Hamilton TE, Ritchey ML, Argani P, et al.: Synchronous bilateral Wilm's tumor with complete radiographic response managed without surgical resection: a report from the National Wilm's Tumor Study 4. J Pediatr Surg 43 (11): 1982-4, 2008.[PUBMED Abstract]

Shamberger RC, Haase GM, Argani P, et al.: Bilateral Wilms' tumors with progressive or nonresponsive disease. J Pediatr Surg 41 (4): 652-7; discussion 652-7, 2006.[PUBMED Abstract]

Ritchey ML, Shamberger RC, Hamilton T, et al.: Fate of bilateral renal lesions missed on preoperative imaging: a report from the National Wilms Tumor Study Group. J Urol 174 (4 Pt 2): 1519-21; discussion 1521, 2005.[PUBMED Abstract]

Breslow NE, Ou SS, Beckwith JB, et al.: Doxorubicin for favorable histology, Stage II-III Wilms tumor: results from the National Wilms Tumor Studies. Cancer 101 (5): 1072-80, 2004.[PUBMED Abstract]

Seibel NL, Li S, Breslow NE, et al.: Effect of duration of treatment on treatment outcome for patients with clear-cell sarcoma of the kidney: a report from the National Wilms' Tumor Study Group. J Clin Oncol 22 (3): 468-73, 2004.[PUBMED Abstract]

Green DM, Grigoriev YA, Nan B, et al.: Congestive heart failure after treatment for Wilms' tumor: a report from the National Wilms' Tumor Study group. J Clin Oncol 19 (7): 1926-34, 2001.[PUBMED Abstract]

Ritchey ML, Shamberger RC, Haase G, et al.: Surgical complications after primary nephrectomy for Wilms' tumor: report from the National Wilms' Tumor Study Group. J Am Coll Surg 192 (1): 63-8; quiz 146, 2001.[PUBMED Abstract]

Green DM, Breslow NE, Beckwith JB, et al.: Comparison between single-dose and divided-dose administration of dactinomycin and doxorubicin for patients with Wilms' tumor: a report from the National Wilms' Tumor Study Group. J Clin Oncol 16 (1): 237-45, 1998.[PUBMED Abstract]

Green DM, Breslow NE, Beckwith JB, et al.: Effect of duration of treatment on treatment outcome and cost of treatment for Wilms' tumor: a report from the National Wilms' Tumor Study Group. J Clin Oncol 16 (12): 3744-51, 1998.[PUBMED Abstract]

Green DM, Breslow NE, Evans I, et al.: Relationship between dose schedule and charges for treatment on National Wilms' Tumor Study-4. A report from the National Wilms' Tumor Study Group. J Natl Cancer Inst Monogr (19): 21-5, 1995.[PUBMED Abstract]

Ritchey ML, Green DM, Breslow NB, et al.: Accuracy of current imaging modalities in the diagnosis of synchronous bilateral Wilms' tumor. A report from the National Wilms Tumor Study Group. Cancer 75 (2): 600-4, 1995.[PUBMED Abstract]

Green D, Beckwith J, Breslow N, et al.: The treatment of children with focal or diffuse, anaplastic Wilms tumor: a report from the National Wilms Tumor Study (NWTS). [Abstract] Proceedings of the American Society of Clinical Oncology 13: A-1408, 413, 1994.

Green DM, Beckwith JB, Breslow NE, et al.: Treatment of children with stages II to IV anaplastic Wilms' Tumor: a report from the National Wilms' Tumor Study Group. J Clin Oncol 12(10): 2126-2131, 1994.

Green DM, Beckwith JB, Weeks DA, et al.: The relationship between microsubstaging variables, age at diagnosis, and tumor weight of children with stage I/favorable histology Wilms' tumor: a report from the National Wilms' Tumor Study. Cancer 74(6): 1817-1820, 1994.

Green DM, Norkool P, Breslow NE, et al.: Severe hepatic toxicity after treatment with vincristine and dactinomycin using single-dose or divided-dose schedules: a report from the National Wilms' Tumor Study. J Clin Oncol 8 (9): 1525-30, 1990.[PUBMED Abstract]

Green DM, Finklestein JZ, Norkool P, et al.: Severe hepatic toxicity after treatment with single-dose dactinomycin and vincristine. A report of the National Wilms' Tumor Study. Cancer 62 (2): 270-3, 1988.[PUBMED Abstract]

Related Publications

Kalapurakal JA, Perlman EJ, Seibel NL, et al.: Outcomes of patients with revised stage I clear cell sarcoma of kidney treated in National Wilms Tumor Studies 1-5. Int J Radiat Oncol Biol Phys 85 (2): 428-31, 2013.[PUBMED Abstract]

Grundy PE, Green DM, Dirks AC, et al.: Clinical significance of pulmonary nodules detected by CT and Not CXR in patients treated for favorable histology Wilms tumor on national Wilms tumor studies-4 and -5: a report from the Children's Oncology Group. Pediatr Blood Cancer 59 (4): 631-5, 2012.[PUBMED Abstract]

Kieran K, Anderson JR, Dome JS, et al.: Lymph node involvement in Wilms tumor: results from National Wilms Tumor Studies 4 and 5. J Pediatr Surg 47 (4): 700-6, 2012.[PUBMED Abstract]

Lange J, Peterson SM, Takashima JR, et al.: Risk factors for end stage renal disease in non-WT1-syndromic Wilms tumor. J Urol 186 (2): 378-86, 2011.[PUBMED Abstract]

Kalapurakal JA, Green DM, Haase G, et al.: Outcomes of children with favorable histology wilms tumor and peritoneal implants treated in National Wilms Tumor Studies-4 and -5. Int J Radiat Oncol Biol Phys 77 (2): 554-8, 2010.[PUBMED Abstract]

Warwick AB, Kalapurakal JA, Ou SS, et al.: Portal hypertension in children with Wilms' tumor: a report from the National Wilms' Tumor Study Group. Int J Radiat Oncol Biol Phys 77 (1): 210-6, 2010.[PUBMED Abstract]

Cotton CA, Peterson S, Norkool PA, et al.: Early and late mortality after diagnosis of wilms tumor. J Clin Oncol 27 (8): 1304-9, 2009.[PUBMED Abstract]

Ehrlich PF, Ferrer FA, Ritchey ML, et al.: Hepatic metastasis at diagnosis in patients with Wilms tumor is not an independent adverse prognostic factor for stage IV Wilms tumor: a report from the Children's Oncology Group/National Wilms Tumor Study Group. Ann Surg 250 (4): 642-8, 2009.[PUBMED Abstract]

Feusner JH, Ritchey ML, Norkool PA, et al.: Renal failure does not preclude cure in children receiving chemotherapy for Wilms tumor: a report from the National Wilms Tumor Study Group. Pediatr Blood Cancer 50 (2): 242-5, 2008.[PUBMED Abstract]

Ritchey M, Daley S, Shamberger RC, et al.: Ureteral extension in Wilms' tumor: a report from the National Wilms' Tumor Study Group (NWTSG). J Pediatr Surg 43 (9): 1625-9, 2008.[PUBMED Abstract]

van den Heuvel-Eibrink MM, Grundy P, Graf N, et al.: Characteristics and survival of 750 children diagnosed with a renal tumor in the first seven months of life: A collaborative study by the SIOP/GPOH/SFOP, NWTSG, and UKCCSG Wilms tumor study groups. Pediatr Blood Cancer 50 (6): 1130-4, 2008.[PUBMED Abstract]

Cotton CA, Peterson S, Norkool PA, et al.: Mortality ascertainment of participants in the National Wilms Tumor Study using the National Death Index: comparison of active and passive follow-up results. Epidemiol Perspect Innov 4: 5, 2007.[PUBMED Abstract]

Breslow NE, Beckwith JB, Haase GM, et al.: Radiation therapy for favorable histology Wilms tumor: prevention of flank recurrence did not improve survival on National Wilms Tumor Studies 3 and 4. Int J Radiat Oncol Biol Phys 65 (1): 203-9, 2006.[PUBMED Abstract]

Breslow NE, Beckwith JB, Perlman EJ, et al.: Age distributions, birth weights, nephrogenic rests, and heterogeneity in the pathogenesis of Wilms tumor. Pediatr Blood Cancer 47 (3): 260-7, 2006.[PUBMED Abstract]

Kalapurakal JA, Breslow NE, Ritchey ML, et al.: Influence of radiation therapy and doxorubicin on abdominal tumor recurrence following tumor spillage among patients with favorable histology Wilms' tumor in NWTS-3 and -4. [Abstract] Int J Radiat Oncol Biol Phys 63 (Suppl 1): A-39, S22, 2005.

Kalapurakal JA, Nan B, Norkool P, et al.: Treatment outcomes in adults with favorable histologic type Wilms tumor-an update from the National Wilms Tumor Study Group. Int J Radiat Oncol Biol Phys 60 (5): 1379-84, 2004.[PUBMED Abstract]

Kalapurakal JA, Li SM, Breslow NE, et al.: Influence of radiation therapy delay on abdominal tumor recurrence in patients with favorable histology Wilms' tumor treated on NWTS-3 and NWTS-4: a report from the National Wilms' Tumor Study Group. Int J Radiat Oncol Biol Phys 57 (2): 495-9, 2003.[PUBMED Abstract]

Porteus MH, Narkool P, Neuberg D, et al.: Characteristics and outcome of children with Beckwith-Wiedemann syndrome and Wilms' tumor: a report from the National Wilms Tumor Study Group. J Clin Oncol 18 (10): 2026-31, 2000.[PUBMED Abstract]

Breslow NE, Partin AW, Lee BR, et al.: Nuclear morphometry and prognosis in favorable histology Wilms' tumor: A prospective reevaluation. J Clin Oncol 17 (7): 2123-6, 1999.[PUBMED Abstract]

Haase GM, Ritchey ML: Nephroblastoma. Semin Pediatr Surg 6 (1): 11-6, 1997.[PUBMED Abstract]

Huff V, Amos CI, Douglass EC, et al.: Evidence for genetic heterogeneity in familial Wilms' tumor. Cancer Res 57 (10): 1859-62, 1997.[PUBMED Abstract]

Altura RA, Valentine M, Li H, et al.: Identification of novel regions of deletion in familial Wilms' tumor by comparative genomic hybridization. Cancer Res 56 (16): 3837-41, 1996.[PUBMED Abstract]

Beckwith JB, Zuppan CE, Browning NG, et al.: Histological analysis of aggressiveness and responsiveness in Wilms' tumor. Med Pediatr Oncol 27 (5): 422-8, 1996.[PUBMED Abstract]

Breslow NE, Olson J, Moksness J, et al.: Familial Wilms' tumor: a descriptive study. Med Pediatr Oncol 27 (5): 398-403, 1996.[PUBMED Abstract]

Grundy P, Coppes M: An overview of the clinical and molecular genetics of Wilms' tumor. Med Pediatr Oncol 27 (5): 394-7, 1996.[PUBMED Abstract]

Grundy P, Telzerow P, Moksness J, et al.: Clinicopathologic correlates of loss of heterozygosity in Wilm's tumor: a preliminary analysis. Med Pediatr Oncol 27 (5): 429-33, 1996.[PUBMED Abstract]

Gunning KB, Cohn SL, Tomlinson GE, et al.: Analysis of possible WT1 RNA processing in primary Wilms tumors. Oncogene 13 (6): 1179-85, 1996.[PUBMED Abstract]

Haase GM: Current surgical management of Wilms' tumor. Curr Opin Pediatr 8 (3): 268-75, 1996.[PUBMED Abstract]

Li FP, Breslow NE, Morgan JM, et al.: Germline WT1 mutations in Wilms' tumor patients: preliminary results. Med Pediatr Oncol 27 (5): 404-7, 1996.[PUBMED Abstract]

Ritchey ML, Green DM, Thomas PR, et al.: Renal failure in Wilms' tumor patients: a report from the National Wilms' Tumor Study Group. Med Pediatr Oncol 26 (2): 75-80, 1996.[PUBMED Abstract]

Sotelo-Avila C, Beckwith JB, Johnson JE: Ossifying renal tumor of infancy: a clinicopathologic study of nine cases. Pediatr Pathol Lab Med 15 (5): 745-62, 1995 Sep-Oct.[PUBMED Abstract]

Breslow NE, Takashima JR, Whitton JA, et al.: Second malignant neoplasms following treatment for Wilm's tumor: a report from the National Wilms' Tumor Study Group. J Clin Oncol 13 (8): 1851-9, 1995.[PUBMED Abstract]

Huff V, Jaffe N, Saunders GF, et al.: WT1 exon 1 deletion/insertion mutations in Wilms tumor patients, associated with di- and trinucleotide repeats and deletion hotspot consensus sequences. Am J Hum Genet 56 (1): 84-90, 1995.[PUBMED Abstract]

Olson JM, Hamilton A, Breslow NE: Non-11p constitutional chromosome abnormalities in Wilms' tumor patients. Med Pediatr Oncol 24 (5): 305-9, 1995.[PUBMED Abstract]

Ritchey ML, Azizkhan RG, Beckwith JB, et al.: Neonatal Wilms tumor. J Pediatr Surg 30 (6): 856-9, 1995.[PUBMED Abstract]

Bardeesy N, Falkoff D, Petruzzi MJ, et al.: Anaplastic Wilms' tumour, a subtype displaying poor prognosis, harbours p53 gene mutations. Nat Genet 7 (1): 91-7, 1994.[PUBMED Abstract]

Gessler M, König A, Arden K, et al.: Infrequent mutation of the WT1 gene in 77 Wilms' Tumors. Hum Mutat 3 (3): 212-22, 1994.[PUBMED Abstract]

Green DM, D'Angio GJ, Beckwith JB, et al.: Wilms tumor. CA Cancer J Clin 46 (1): 46-63, 1996 Jan-Feb.[PUBMED Abstract]

Grundy PE, Telzerow PE, Breslow N, et al.: Loss of heterozygosity for chromosomes 16q and 1p in Wilms' tumors predicts an adverse outcome. Cancer Res 54 (9): 2331-3, 1994.[PUBMED Abstract]

Grundy P, Wilson B, Telzerow P, et al.: Uniparental disomy occurs infrequently in Wilms tumor patients. Am J Hum Genet 54 (2): 282-9, 1994.[PUBMED Abstract]

Leisenring WM, Breslow NE, Evans IE, et al.: Increased birth weights of National Wilms' Tumor Study patients suggest a growth factor excess. Cancer Res 54 (17): 4680-3, 1994.[PUBMED Abstract]

Steenman MJ, Rainier S, Dobry CJ, et al.: Loss of imprinting of IGF2 is linked to reduced expression and abnormal methylation of H19 in Wilms' tumour. Nat Genet 7 (3): 433-9, 1994.[PUBMED Abstract]

Olshan AF, Breslow NE, Falletta JM, et al.: Risk factors for Wilms tumor. Report from the National Wilms Tumor Study. Cancer 72 (3): 938-44, 1993.[PUBMED Abstract]

Olson JM, Breslow NE, Barce J: Cancer in twins of Wilms tumor patients. Am J Med Genet 47 (1): 91-4, 1993.[PUBMED Abstract]

Gearhart JP, Partin AW, Leventhal B, et al.: The use of nuclear morphometry to predict response to therapy in Wilms' tumor. Cancer 69 (3): 804-8, 1992.[PUBMED Abstract]

Maw MA, Grundy PE, Millow LJ, et al.: A third Wilms' tumor locus on chromosome 16q. Cancer Res 52 (11): 3094-8, 1992.[PUBMED Abstract]

Grundy P, Telzerow P, Paterson MC, et al.: Chromosome 11 uniparental isodisomy predisposing to embryonal neoplasms. Lancet 338(8774): 1079-1080, 1991.

Heppe RK, Koyle MA, Beckwith JB: Nephrogenic rests in Wilms tumor patients with the Drash syndrome. J Urol 145 (6): 1225-8, 1991.[PUBMED Abstract]

D'Angio GJ: Hepatotoxicity and actinomycin D. Lancet 335(8700): 1290, 1990.

D'Angio GJ: Chemotherapy and veno-occlusive disease of the liver. Pediatr Hematol Oncol 6(1): 51, 1989.

Beckwith JB: The John Lattimer Lecture: Wilms tumor and other renal tumors of childhood: an update. J Urol 136(1, Part 2): 320-324, 1986.

Breslow NE, Churchill G, Nesmith B, et al.: Clinicopathologic features and prognosis for Wilms' tumor patients with metastases at diagnosis. Cancer 58 (11): 2501-11, 1986.[PUBMED Abstract]

Hrabovsky EE, Othersen HB Jr, deLorimier A, et al.: Wilms' tumor in the neonate: a report from the National Wilms' Tumor Study. J Pediatr Surg 21 (5): 385-7, 1986.[PUBMED Abstract]

Mitchell CD, D'Angio GJ: Does cyclophosphamide (CPM) improve survival rates in patients with solid tumors? Am J Clin Oncol 9 (4): 277-80, 1986.[PUBMED Abstract]

Trial Contact Information

Trial Lead Organizations

National Wilms' Tumor Study Group

Daniel Green, MD, Protocol chair (Contact information may not be current)
Ph: 716-845-2334; 800-685-6825

Children's Cancer Group

Jerry Finklestein, MD, Protocol chair (Contact information may not be current)
Ph: 310-825-5268; 888-798-0719

Pediatric Oncology Group

Paul Grundy, MD, Protocol chair (Contact information may not be current)
Ph: 780-432-8894

Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol.

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