Projects we fund

Overview

Wilms’ tumour is a cancer of the kidney. Around 80 children in the UK are diagnosed with it every year – most of them under five. Overall, around 90% survive, but there are different sub-types of Wilms’ and we’re not able to treat all of them so successfully. Children with Wilms’ are given chemotherapy for four to six weeks, to shrink the tumour before surgery. More chemotherapy is usually given after surgery to reduce the risk of the tumour returning. Certain types of Wilms’ tumour respond well to this, but others don’t. Currently we can only find out which type of Wilms’ a child has by examining the tumour after it’s been removed. Then we can see which children have a high-risk type and give them more intensive treatment. If we could identify the tumour sub-type as soon as it’s diagnosed, doctors could tailor treatment sooner, giving the child a better chance of recovery. We’d also know whether the child had a high-risk tumour before we operated, which could reduce the risk of relapse.

What difference will the project make?

Building on a successful pilot study, Professor Chris and his team will explore how an advanced MRI technique known as diffusion-weighted imaging (DWI) could determine a Wilms’ tumour sub-type without surgery, and predict its response to chemotherapy. The team will carry out a DWI scan in each child before and after pre-operative chemotherapy. When the tumour has been removed they’ll examine it to confirm its subtype, and send it for molecular analysis to check for genetic alterations. What they find will show how the tumour has changed as a result of chemotherapy, helping us to understand the differences in how the sub-types of Wilms’ respond. Then the DWI data will be combined with data from the microscopic examinations and the molecular analyses to see if, in future, the imaging data alone could be used to determine which children have a high-risk tumour. In future, this should help doctors decide on the right type of chemotherapy, and plan the timing of surgery based on the child’s individual needs, especially important if both kidneys have been affected. This personalised treatment will help more children with high risk Wilms’ to survive, and also mean that children with standard- and low- risk sub-types can have less aggressive treatment with fewer potential side effects.