In the Netherlands, about 35 children are found with a tumor in the kidney every year. The majority of these children have a so-called nephroblastoma, also called Wilms tumor. Thanks to international cooperation and research, much progress has been made and 9 out of 10 children are cured. Prof. Dr. Marry van den Heuvel-Eibrink, paediatric oncologist and research group leader at the Princess Máxima Center: ‘The challenges lie in the 10% of children with a Wilms tumor that we cannot cure and in the rarer forms that are unfortunately even less easy to treat, for example because they are less sensitive or even not at all sensitive to chemotherapy. In addition, a major challenge is to enable the quality of survival with fewer side effects for most children. Research therefore remains very important to eventually be able to cure all children with a kidney tumor, with limited long-term damage.'
Better diagnostics and treatment for all tumor types
Van den Heuvel-Eibrink worked on an initial five-year evaluation that was published earlier this year in PLOS One. The researchers compared the Máxima center’s figures with those from the Dutch Cancer Registry (NKR). The NKR collects information on, for example, the type of tumor and the outcome of treatment. ‘An important difference between our figures and those of the NKR is that in the Máxima hospital we register a kidney tumor in ten extra children every year. This is because we also register the rare kidney tumor forms. We collect information from all these children. Because of this we can now also use and develop better diagnostic techniques and treatments for the rare forms,' says van den Heuvel-Eibrink.
In the Máxima hospital children are treated by a team consisting of doctors with various specializations, also known as a multidisciplinary expertise team. 'Children with a kidney tumor appear to benefit greatly from this.' Together with Dr. Jarno Drost, research group leader at the Máxima center and one of the co-authors of the study, van den Heuvel-Eibrink coordinates a theme group focused on children with kidney cancer in which doctors and researchers work together. They supervised the creation of the publication and the analyses that form its basis.
Data from the Biobank
When a child is diagnosed with a tumor, in most cases both tumor and healthy tissue and blood are collected. After permission has been granted, this is stored for the international biobank (SIOP-RTSG) and in the Máxima center’s Biobank. Because such material will be collected in one place from 2015 onwards, researchers participating in certain projects in the Netherlands and abroad will have access to biological research material and information from the entire group of children with kidney tumors from 2015 onwards. Drost's research group grows organoids, or mini-tumors, using this material. ‘With these organoids we investigate the so-called genesis cell of the tumor, but also why a particular cancer grows so quickly. Also, drugs can be tested on these mini-tumors and even new drugs, directed against the specific cancer cell, can be discovered and developed,' says Drost.
‘The integration of care and research means that new developments from research can be applied more quickly. It is very nice to take the field further with this research and to be able to share our experiences from daily practice and research with other pediatric cancer centers in the rest of the world,' van den Heuvel-Eibrink concludes.