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Less intensive chemo avoids side effects in children

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A type of rare children’s cancer can successfully be treated with less intensive chemotherapy that avoids irreversible side effects, according to latest research.

Children with a Wilms’ tumour, who are at low risk of relapsing, can now be given less intensive treatment, avoiding a type of chemotherapy that can cause irreversible heart problems in later life.

“Fewer children with this disease will have to have treatment that could cause them lifelong side effects without much benefit”

Kathy Pritchard-Jones

The move follows the results of a Cancer Research UK trial, published in The Lancet, showing the drug doxorubicin can be safely omitted from treatment without affecting chances of survival.

Wilms’ tumour is a type of kidney cancer that affects around 80 children a year in the UK, mostly under the age of seven.

Until now, about one half of these patients would have received doxorubicin as part of their treatment, which carries a small but significant risk of heart problems in later life.

Now, based on the new study, only about one quarter of children – those at the greatest risk of relapse – need the drug.

The latest study involved 583 children with stage II or stage III Wilms’ tumour, who were at intermediate risk of relapsing. They took part in the 10-year trial from 2001-2011 across 26 European countries.

The results showed that 96.5% of children whose treatment included doxorubicin survived for five years or more, compared with 95.8% of children who did not receive the drug.

Although there were slightly more relapses among those who avoided doxorubicin, the study found they could all be successfully re-treated, meaning there was no impact on overall mortality risk.

“We’re learning how we can both improve treatments for children’s cancers alongside reducing the damaging side effects”

Pam Kearns

Lead author Professor Kathy Pritchard-Jones, from the Institute of Child Health at University College London, said: “Thanks to the results of this trial fewer children with this disease will have to have treatment that could cause them lifelong side effects without much benefit.”

Professor Pam Kearns, professor of paediatric oncology at Birmingham University and Cancer Research UK’s senior clinical advisor, said: “This is a very important trial that has changed clinical practice for this type of Wilms’ tumour.

“Around nine in 10 children with the disease survive with current treatments, so it is difficult to consider reducing treatment, but minimising the side effects that occur later in life is crucial,” she said.

She added: “Thanks to trials like this we’re learning how we can both improve treatments for children’s cancers alongside reducing the damaging side effects.”

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