New Treatments & Clinical Trials for Wilms Tumor

Wilms tumor is a kidney cancer that occurs almost exclusively in children, typically before age 5. It accounts for most childhood kidney cancers. Current treatment combines surgery, chemotherapy, and sometimes radiation, with cure rates above 90% for most cases. Research now focuses on reducing treatment intensity for lower-risk tumors and improving outcomes for the small fraction with high-risk features.

What's actually going on in research

Trials are testing whether children with favorable tumors can receive less chemotherapy or avoid radiation entirely, reducing long-term side effects while maintaining cure rates. For higher-risk disease, studies are exploring targeted drugs that attack specific tumor mutations and new combinations that might improve outcomes for the 10% who don't respond to standard treatment.

What to know before you search

Eligibility typically depends on tumor stage, whether it has favorable or unfavorable features under the microscope, whether cancer is in one or both kidneys, and prior treatment if the tumor has returned.

What types of trials are currently open

• Risk-adapted trials — Testing whether children with favorable tumors can receive less intensive treatment—fewer chemotherapy cycles, lower doses, or no radiation—while maintaining high cure rates.
• Surgery timing studies — Comparing upfront surgery versus chemotherapy before surgery to see which approach works better for different tumor stages.
• High-risk treatment trials — Testing new drug combinations or targeted therapies for tumors with unfavorable features or those that come back after initial treatment.
• Imaging studies — Testing whether newer scans can better identify which tumors need more or less intensive treatment.
• Long-term follow-up studies — Tracking survivors to understand late effects of treatment and how to prevent problems like heart disease and second cancers.