Combination Chemotherapy Alone or With Radiation Therapy in Treating Children With Kidney Cancer
Kidney Cancer
About this trial
This is an interventional treatment trial for Kidney Cancer focused on measuring stage I Wilms tumor, stage II Wilms tumor, stage III Wilms tumor, stage IV Wilms tumor, stage V Wilms tumor, clear cell sarcoma of the kidney
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed stage I-V kidney cancer of one of the following histologies: Wilms' tumor, favorable histology Wilms' tumor, focal or diffuse anaplastic Clear cell sarcoma Rhabdoid tumor (The rhabdoid tumor stratum closed to accrual effective 07/13/2001) Prior nephrectomy or biopsy required Prior bilateral biopsy (preferably open) with bilateral staging and pathologic evaluation required for bilateral tumor Must begin study therapy within 5 days after nephrectomy (unless medically contraindicated) PATIENT CHARACTERISTICS: Age: Under 16 Performance status: Not specified Life expectancy: Not specified Hematopoietic: Not specified Hepatic: Not specified Renal: Not specified Other: Not pregnant Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: No prior chemotherapy Endocrine therapy: Not specified Radiotherapy: No prior radiotherapy Surgery: See Disease Characteristics
Sites / Locations
- University of Alabama at Birmingham Comprehensive Cancer Center
- University of South Alabama Medical Center
- Phoenix Children's Hospital
- Arizona Cancer Center
- University of Arkansas for Medical Sciences
- Southern California Permanente Medical Group
- City of Hope Comprehensive Cancer Center
- Rebecca and John Moores UCSD Cancer Center
- Loma Linda University Medical Center
- Jonathan Jaques Children's Cancer Center
- Children's Hospital Los Angeles
- Cedars-Sinai Medical Center
- Jonsson Comprehensive Cancer Center, UCLA
- Children's Hospital Central California
- Children's Hospital of Oakland
- Chao Family Comprehensive Cancer Center
- Children's Hospital of Orange County
- Lucile Packard Children's Hospital at Stanford
- Sutter Cancer Center
- University of California Davis Medical Center
- Kaiser Permanente Medical Center/Kaiser Foundation Hospital - San Diego
- Children's Hospital San Diego
- Kaiser Permanente Medical Center - San Francisco Geary Campus
- UCSF Comprehensive Cancer Center
- Santa Barbara Cottage Hospital
- Kaiser Permanente Medical Center - Santa Clara
- David Grant Medical Center
- Children's Hospital of Denver
- Childhood Hematology/Oncology Associates
- Presbyterian-St Luke's Medical Center
- University of Connecticut Health Center
- Yale Comprehensive Cancer Center
- Alfred I. Dupont Institute
- Lombardi Cancer Center
- Children's National Medical Center
- Walter Reed Army Medical Center
- Broward General Medical Center
- Children's Hospital of Southwest Florida
- Shands Hospital and Clinics, University of Florida
- Joe DiMaggio Children's Hospital at Memorial
- Nemours Children's Clinic
- University of Miami-Jackson Memorial Hospital
- Miami Children's Hospital
- Baptist Hospital of Miami
- Florida Hospital Cancer Institute
- Nemours Children's Clinic-Orlando
- Sacred Heart Children's Hospital
- All Children's Hospital
- Tampa Children's Hospital
- St. Mary's Hospital
- Emory University Hospital - Atlanta
- Children's Healthcare of Atlanta - Scottish Rite
- Medical College of Georgia Comprehensive Cancer Center
- Medical Center of Central Georgia
- Memorial Health University Medical Center, Inc.
- Cancer Research Center of Hawaii
- MBCCOP - Hawaii
- Tripler Army Medical Center
- Mountain States Tumor Institute
- University of Chicago Cancer Research Center
- Rush-Presbyterian-St. Luke's Medical Center
- University of Illinois at Chicago
- Children's Memorial Hospital - Chicago
- Hope Children's Hospital
- Lutheran General Hospital
- Saint Jude Midwest Affiliate
- Southern Illinois University School of Medicine
- Indiana University Cancer Center
- St. Vincent Hospital and Health Care Center
- Raymond Blank Memorial Hospital for Children
- John Stoddard Cancer Center
- Holden Comprehensive Cancer Center
- Wesley Medical Center
- Albert B. Chandler Medical Center, University of Kentucky
- Kosair Children's Hospital
- Tulane University School of Medicine
- Children's Hospital of New Orleans
- Ochsner Clinic
- Eastern Maine Medical Center
- Maine Children's Cancer Program
- Marlene and Stewart Greenebaum Cancer Center, University of Maryland
- Sinai Hospital of Baltimore
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
- Floating Hospital for Children
- Dana-Farber Cancer Institute
- Baystate Medical Center
- University of Massachusetts Memorial Medical Center - University Campus
- Mott Children's Hospital
- Children's Hospital of Michigan
- Henry Ford Hospital
- St. John Hospital and Medical Center
- Michigan State University
- Hurley Medical Center
- Spectrum Health and DeVos Children's Hospital
- Bronson Methodist Hospital
- CCOP - Beaumont
- William Beaumont Hospital
- St. Mary's/Duluth Clinic Cancer Center
- Children's Hospitals and Clinics - Minneapolis
- Mayo Clinic Cancer Center
- Children's Hospitals and Clinics of Minnesota
- University of Mississippi Medical Center
- Children's Mercy Hospital
- Cardinal Glennon Children's Hospital
- St. Louis Children's Hospital
- Children's Hospital of Omaha
- University of Nebraska Medical Center
- Sunrise Hospital and Medical Center
- Norris Cotton Cancer Center
- Hackensack University Medical Center
- Cancer Institute of New Jersey
- Newark Beth Israel Medical Center
- St. Joseph's Hospital and Medical Center
- Atlantic Health System
- University of New Mexico Cancer Research and Treatment Center
- Cancer Center of Albany Medical Center
- Albert Einstein Clinical Cancer Center
- Brooklyn Hospital Center
- State University of New York Health Science Center at Brooklyn College of Medicine
- Brookdale University Hospital and Medical Center
- Maimonides Medical Center
- Roswell Park Cancer Institute
- North Shore University Hospital
- Schneider Children's Hospital
- New York Presbyterian Hospital - Cornell Campus
- Memorial Sloan-Kettering Cancer Center
- Mount Sinai School of Medicine
- Columbia Presbyterian Hospital
- James P. Wilmot Cancer Center
- State University of New York Health Sciences Center - Stony Brook
- State University of New York - Upstate Medical University
- New York Medical College
- Mission Saint Joseph's Health System
- Lineberger Comprehensive Cancer Center, UNC
- Carolinas Medical Center
- Presbyterian Healthcare
- Duke Comprehensive Cancer Center
- East Carolina University School of Medicine
- Comprehensive Cancer Center at Wake Forest University
- Dakota Cancer Institute
- Children's Hospital Medical Center of Akron
- Children's Hospital Medical Center - Cincinnati
- Ireland Cancer Center
- Cleveland Clinic Taussig Cancer Center
- Children's Hospital of Columbus
- Children's Medical Center - Dayton
- Toledo Children's Hospital
- St. Vincent Mercy Medical Center
- Forum Health-Tod Childrens Hospital
- Children's Hospital of Oklahoma
- CCOP - Oklahoma
- Natalie Warren Bryant Cancer Center
- Doernbecher Children's Hospital
- Legacy Emanuel Hospital and Health Center
- Geisinger Medical Center
- Milton S. Hershey Medical Center
- Children's Hospital of Philadelphia
- St. Christopher's Hospital for Children
- Children's Hospital of Pittsburgh
- Rhode Island Hospital
- Medical University of South Carolina
- Palmetto Health South Carolina Cancer Center
- Children's Hospital of Greenville Hospital System
- Avera Cancer Institute
- Sioux Valley Hospital
- East Tennessee State University Cancer Center at JCMC
- East Tennessee Children's Hospital
- Saint Jude Children's Research Hospital
- Vanderbilt-Ingram Cancer Center
- Texas Tech University Health Sciences Center School of Medicine
- Children's Hospital of Austin
- Medical City Dallas Hospital
- Simmons Cancer Center - Dallas
- Cook Children's Medical Center - Fort Worth
- University of Texas Medical Branch
- University of Texas - MD Anderson Cancer Center
- Baylor College of Medicine
- San Antonio Military Pediatric Cancer and Blood Disorders Center
- Covenant Children's Hospital
- University of Texas Health Science Center at San Antonio
- Methodist Health Care System
- Scott and White Memorial Hospital
- Huntsman Cancer Institute
- Vermont Cancer Center
- Cancer Center at the University of Virginia
- Inova Fairfax Hospital
- Children's Hospital of the King's Daughters
- Naval Medical Center, Portsmouth
- Massey Cancer Center
- Carilion Medical Center for Children
- Children's Hospital and Regional Medical Center - Seattle
- Fred Hutchinson Cancer Research Center
- Group Health Cooperative
- Deaconess Medical Center
- Mary Bridge Children's Health Center
- Madigan Army Medical Center
- West Virginia University - Charleston
- Cabell-Huntington Hospital, Inc
- West Virginia University Hospitals
- Bellin Memorial Hospital
- CCOP - St. Vincent Hospital Cancer Center, Green Bay
- St. Vincent Hospital
- Gundersen Lutheran Medical Center
- University of Wisconsin Hospital and Clinics
- Marshfield Clinic
- Midwest Children's Cancer Center
- Sydney Children's Hospital
- Children's Hospital at Westmead
- Royal Children's Hospital
- Women's and Children's Hospital
- Royal Children's Hospital
- Princess Margaret Hospital for Children
- Alberta Children's Hospital
- Cross Cancer Institute
- British Columbia Children's Hospital
- CancerCare Manitoba
- Janeway Children's Health and Rehabilitation Centre
- IWK Health Centre
- Children's Hospital
- Children's Hospital of Western Ontario
- Children's Hospital of Eastern Ontario
- Hospital for Sick Children
- McGill University Health Center - Montreal Children's Hospital
- Hopital Sainte Justine
- Centre Hospitalier de L'Universite Laval
- Laval University Medical Center
- Allan Blair Cancer Centre
- Saskatoon Cancer Centre
- Academisch Ziekenhuis Groningen
- Starship Children's Hospital
- University of Puerto Rico School of Medicine Medical Sciences Campus
- San Jorge Childrens Hospital
- Swiss Pediatric Oncology Group Bern
- Swiss Pediatric Oncology Group Geneva
- Swiss Pediatric Oncology Group Lausanne
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Arm 8
Arm 9
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Stratum 1
Stratum 2
Stratum 3
Stratum 4
Stratum 5
Stratum 6
Stratum 7
Stratum 8
Stratum 9
Stage I favorable histology (FH) Wilms' tumor, under 24 months of age, and tumor weight less than 550 g: After conventional surgery (nephrectomy), patients receive regimen EE-4A comprising dactinomycin (DACT) IV weekly on weeks 0, 3, 6, 9, 12, 15, and 18 and vincristine sulfate (VCR) IV weekly on weeks 1-10, 12, 15, and 18.
Stage I FH Wilms' tumor and age 24 months and over or tumor weight at least 550 g; stage I focal anaplastic (FA) or diffuse anaplastic (DA) Wilms' tumor: Patients receive regimen EE-4A comprising dactinomycin (DACT) IV weekly on weeks 0, 3, 6, 9, 12, 15, and 18 and vincristine sulfate (VCR) IV weekly on weeks 1-10, 12, 15, and 18.
Stage II FH Wilms' tumor: Patients receive regimen EE-4A comprising dactinomycin (DACT) IV weekly on weeks 0, 3, 6, 9, 12, 15, and 18 and vincristine sulfate (VCR) IV weekly on weeks 1-10, 12, 15, and 18.
Stage III FH Wilms' tumor; stage II or III FA Wilms' tumor: After conventional surgery (nephrectomy), patients receive regimen DD-4A comprising dactinomycin DACT IV weekly on weeks 0, 6, 12, 18, and 24; doxorubicin hydrochloride IV weekly on weeks 3, 9, 15, and 21; and vincristine sulfate VCR IV weekly on weeks 1-10, 12, 15, 18, 21, and 24. Patients also undergo abdominal radiation therapy.
Stage IV FH or FA Wilms' tumor: patients receive regimen DD-4A comprising dactinomycin DACT IV weekly on weeks 0, 6, 12, 18, and 24; doxorubicin hydrochloride IV weekly on weeks 3, 9, 15, and 21; and vincristine sulfate VCR IV weekly on weeks 1-10, 12, 15, 18, 21, and 24. Patients also undergo abdominal radiation therapy, and whole lung radiation therapy (at the discretion of the investigator).
Stage V FH, FA, or DA Wilms' tumor: After bilateral conventional surgery (biopsy), patients with FH receive chemotherapy as in stratum 1 (dactinomycin IV weeks 0, 3, 6, 9, 12, 15, and 18 and vincristine sulfate IV weeks 1-10, 12, 15, and 18) or 4 (dactinomycin IV weeks 0, 6, 12, 18, and 24; doxorubicin hydrochloride IV weeks 3, 9, 15, and 21; and vincristine sulfate VCR IV weeks 1-10, 12, 15, 18, 21, and 24). Patients with FA or DA receive chemotherapy as in stratum 7 (vincristine sulfate VCR IV weeks 1, 2, 4-8, 10-13, 18, and 24; cyclophosphamide sulfate (CTX) IV over 1 hour on days 1-3 of weeks 6, 12, 18, and 24 and on days 1-5 of weeks 3, 9, 15, and 21; doxorubicin hydrochloride IV (beginning after CTX infusion) weeks 0, 6, 12, 18, and 24; and etoposide (VP-16) IV over 1 hour (beginning after CTX infusion) on days 1-5 of weeks 3, 9, 15, and 21. Filgrastim (G-CSF) is administered subcutaneously (SC) beginning 24 hours after completion of chemotherapy.
Stages I-IV clear cell sarcoma): After conventional surgery (nephrectomy), patients receive vincristine sulfate VCR IV weekly on weeks 1, 2, 4-8, 10-13, 18, and 24; cyclophosphamide sulfate (CTX) IV over 1 hour on days 1-3 of weeks 6, 12, 18, and 24 and on days 1-5 of weeks 3, 9, 15, and 21; doxorubicin hydrochloride IV (beginning after CTX infusion) weekly on weeks 0, 6, 12, 18, and 24; and etoposide (VP-16) IV over 1 hour (beginning after CTX infusion) on days 1-5 of weeks 3, 9, 15, and 21. Filgrastim (G-CSF) is administered subcutaneously (SC) beginning 24 hours after completion of chemotherapy and continuing until blood counts recover. Patients also undergo abdominal radiotherapy and whole lung radiotherapy (if pulmonary metastases are present).
Stages II-IV DA Wilms' tumor: After conventional surgery (nephrectomy), Patients receive treatment as in stratum 7 (patients receive vincristine sulfate VCR IV weekly on weeks 1, 2, 4-8, 10-13, 18, and 24; cyclophosphamide sulfate (CTX) IV over 1 hour on days 1-3 of weeks 6, 12, 18, and 24 and on days 1-5 of weeks 3, 9, 15, and 21; doxorubicin hydrochloride IV (beginning after CTX infusion) weekly on weeks 0, 6, 12, 18, and 24; and etoposide (VP-16) IV over 1 hour (beginning after CTX infusion) on days 1-5 of weeks 3, 9, 15, and 21. Filgrastim (G-CSF) is administered subcutaneously (SC) beginning 24 hours after completion of chemotherapy and continuing until blood counts recover. Patients also undergo abdominal radiotherapy and whole lung radiotherapy (if pulmonary metastases are present).
Stages I-IV rhabdoid tumor: After conventional surgery (nephrectomy), patients receive carboplatin IV on days 1-2 and VP-16 IV over 1 hour (beginning after carboplatin infusion) on days 1-3 of weeks 0, 3, 9, 12, 18, and 21 and CTX IV over 1 hour on days 1-5 of weeks 6, 15, and 24. Filgrastim G-CSF is administered as on stratum 7. Patients also undergo radiation therapy. After completion of chemotherapy, patients undergo second-look conventional surgery (laparotomy) and conventional surgery (partial nephrectomy or wedge excision if feasible). After conventional surgery (second-look surgery), patients without persistent or residual disease resume chemotherapy.