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AREN0532 tested treating the lowest-risk Wilms tumours with surgery alone and no chemotherapy, and giving more treatment only to children whose tumours carried particular chromosome losses; both ideas worked and now guide how much therapy each child gets.
AREN0532 was the Children's Oncology Group's risk-stratified trial for favourable-histology Wilms tumour, enrolling 808 children. Those under two years with small stage I tumours (very low risk) had nephrectomy alone and were watched; the standard-risk groups received vincristine and dactinomycin, with doxorubicin and radiotherapy added by stage, and those whose tumours showed loss of heterozygosity at both 1p and 16q, a marker of relapse identified in NWTS-5, were moved to more intensive regimens.
Surgery alone gave excellent survival in the very low-risk group, with the few relapses salvaged, and augmenting therapy for the 1p/16q loss group improved event-free survival compared with historical controls. The trial embedded molecular risk markers in Wilms tumour treatment for the first time.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
808 enrolled.
95% CI 79 to 98 · 95% CI 73 to 100 · 95% CI 85 to 91
Source95% CI 95 to 99
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Event-free survival at 4 years by risk group (registry results)primary | Very low risk (surgery alone) | - | 88% | - | - | link |
| Standard risk, stage I or II with loss of heterozygosity at 1p and 16q | - | 87% | ||||
| Standard risk, stage III | - | 88% | ||||
| Overall survival at 4 years by risk group (registry results)primary | Very low risk (surgery alone) | - | 100% | - | - | link |
| Standard risk, stage I or II with loss of heterozygosity at 1p and 16q | - | 100% | ||||
| Standard risk, stage III | - | 97% |
Shares Children's Oncology Group (COG), Vincristine, Cytotoxic chemotherapy and the tag subtype-trials.
Shares Children's Oncology Group (COG), Cytotoxic chemotherapy and the tag subtype-trials.
Shares Vincristine, Cytotoxic chemotherapy and the tag subtype-trials.
Shares Vincristine, Doxorubicin and the tag subtype-trials.
Shares Cytotoxic chemotherapy and the tag subtype-trials.
Shares Doxorubicin, Cytotoxic chemotherapy and the tag subtype-trials.
Shares Doxorubicin, Cytotoxic chemotherapy and the tag subtype-trials.
Shares Cytotoxic chemotherapy and the tag subtype-trials.