Summary
A study was begun in 1971 at St. Bartholomew's Hospital with a combination of 4 drugs, dactinomycin (actinomycin D), adriamycin, vincristine and Endoxan (cyclophosphamide) (D.A.V.E.), together with surgery and radiation, in the treatment of stage III and stage IV Wilms' tumour. Seventy-one percent of the children treated achieved complete response. The median survival from diagnosis was 19 months, and in those children achieving complete response the median disease-free survival has not yet been reached. Toxicity was not a serious problem.
The study group is compared with a group of children treated at this hospital before 1971. There is an improved survival in the children treated with D.A.V.E. Children who have relapsed with stage I or stage II disease may also respond.
This four-drug combination was well tolerated and effective, and confirms recent experience suggesting that intensive multiple-drug regimens may be curative even in advanced disease.
Similar content being viewed by others
References
Beckwith JB, Palmer NF (1978) Histopathology and prognosis of Wilms' tumour. Cancer 41:1937
Bellani FF (1975) Adriamycin in Wilms' tumour previously treated with chemotherapy. Eur J Cancer 11:593
D'Angio GJ, Farber S (1959) Potentiation of x-ray effects by actinomycin D. Radiology 73:175
D'Angio GJ, Beckwith JB (1979) Results of the Second National Wilms' tumour study (NWTS-2). Proc Am Soc Clin Oncol 20:74
D'Angio GJ, Beckwith JB (1980) Wilms' tumour: An Update. Cancer 45:1791
Farber S (1966) Chemotherapy in the treatment of leukaemia and Wilms' tumour. JAMA 198:826–836
Farber S (1960) Clinical studies of actinomycin D with special reference to Wilms' tumour in children. Ann NY Acad Sci 89:421
Gross RE, Neuhauser EBD (1950) Treatment of mixed tumours of the kidney in childhood. Pediatrics 6:843
Jenkin RDT, Jeffs RD (1976) Wilms' tumour: adjuvant treatment with actinomycin D and Vincristine. CMA Journal 115:136
Margolis LW, Byron Smith (1973) Wilms' tumour — An interdisciplinary treatment program with and without actinomycin D Cancer 32:618
Ortega JA, Higgins GR (1980) Vincristine, dactinomycin and cyclophosphamide (VAC) chemotherapy for recurrent metastatic Wilms' tumour in previously treated children. J Paediatr 96:502
Pinedo HM, Kenis Y (1977) Chemotherapy of advanced soft-tissue sarcoma in adults. Cancer Treat Rev 4:67
Sutow WW (1967) Cyclophosphamide in Wilms' tumour and rhabdomyosarcoma. Cancer Chemother Rep 51:407
Sutow WW, Thurman WG, Windmiller J (1963) Vincristine (Leurocristine) sulfate in the treatment of children with metastatic Wilms' tumour. Pediatrics 32:880
Vietti TJ, Sullivan MP (1970) Vincristine sulfate and radiation therapy in metastatic Wilm's tumour. Cancer 25:12
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dunger, D.B., Malpas, J.S., Graham-Pole, J.R. et al. The use of four-drug combination chemotherapy (D.A.V.E.) in the treatment of advanced Wilms' tumour. Cancer Chemother. Pharmacol. 5, 211–215 (1981). https://doi.org/10.1007/BF00434386
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00434386