Wilms Tumor

Dr. Lovvorn directs a basic research laboratory through Vanderbilt that welcomes collaborative investigation from low-middle income nations, and particularly Kenya. Funding for this effort originates from extramural sources, principally the National Cancer Institute. The subjects of our research are multiple, but from an international health perspective, we study the childhood cancer health disparity posed by Wilms tumor principally on black populations of sub-Saharan Africa. Our lab has been instrumental in delineating peptide signatures and genomic alterations in Wilms tumor specimens from Kenya, attempting to correlate these molecular findings with outcome. In this process, as one might imagine, Kenyan patients (as a paradigm for any in developing countries) often abandon their care and/or become lost to follow up, which together challenges accurate assignment of poor prognostic biology to adverse events (as the majority seem to have an unfavorable outcome, and we are often unable to track patients' true response to therapy when lost to follow up). Nevertheless, we are implementing a standardized treatment protocol and educational platform to retain patients in therapy, and we hope to go live with that program this coming fiscal year (2016). Such standardization of therapy will allow (we hope) better survival from WT, less treatment-associated toxicity, and clearer assessment of the clinical significance of certain biological markers. This standardized protocol also will incorporate methods to track precise chemotherapy dosing, response to this therapy, and correlation with biological markers to risk stratify treatment, as is currently implemented through COG protocols.