Survival of patients with renal cell carcinoma (RCC) is affected by stage of disease at presentation and the completeness of resection at radical nephrectomy. Overall survival rates range from 64% to 87%. The 5-year survival for stage I is 90% or higher, for stages II and III it is 50% to 80%, and for stage IV it is 9%, which is similar to the stage-for-stage survival in RCC in adults. Retrospective analyses and the small number of patients involved place limitations on the level of evidence in the area of treatment. The primary treatment for RCC includes total surgical removal of the kidney and associated lymph nodes. In two small series, patients who had partial nephrectomies seemed to have outcomes equivalent to those who had radical nephrectomies. Partial nephrectomy may be considered in carefully selected patients with low-volume localized disease.[2,3] There is some suggestion that regional lymph node involvement does not portend the same poor prognosis as adult renal cell carcinoma. However, this is controversial as the finding are based on only 13 patients. Treatment of unresectable metastatic disease is presently unsatisfactory, similar to adult RCC; it is poorly responsive to radiation and there is no effective chemotherapy regimen. Immunotherapy, such as interferon-alpha and interleukin-2, may have some effect on cancer control. Rare spontaneous regression of pulmonary metastasis may occur with resection of the primary tumor. Several targeted agents (for example, sorafenib, sunitinib, bevacizumab, temsirolimus, pazopanib, and everolimus) have been approved for use in adults with RCC; however, these agents have not been tested in pediatric patients with RCC. However, a case report of an adolescent with a TFE-3 RCC suggests responsiveness to multiple tyrosine kinase inhibitors. (Refer to the PDQ summary on adult Renal Cell Cancer Treatment for more information.)
Newcastle disease virus (NDV) is a virus that is of interest because it replicates (makes copies of itself) more quickly in human cancer cells than in most normal human cells and because it can kill these host cells (see Question 1).
NDV can be used to directly kill cancer cells, or it can be given as a cancervaccine. Cancer vaccines cause the body's natural immune system to seek out and destroy cancer cells (see Question 4).
The results of clinical trials (research studies with people)...
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood renal cell carcinoma. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.