About

Project

Wilms tumour (WT) is one of the common and curable cancer types targeted by the Global Initiative for Childhood Cancer. The Wilms Africa Project has been developing, implementing and evaluating adapted treatment guidelines for Wilms tumour in low-income countries, especially sub-Saharan Africa, aiming to improve care and survival.

It started with a pilot project in Blantyre, Malawi where from 2006 – 2008 an adapted treatment guideline, including preoperative chemotherapy, nutritional support and strategies to enable families to complete treatment was introduced. This programme was associated with an increase in completion of treatment, survival and created essential local evidence.

Based upon the findings in Malawi and the international guidelines for the treatment of Wilms tumour in Europe and North America a SIOP PODC consensus treatment guideline was published in 2013 which was used for the Wilms Africa Phase I (2014 – 2018) project in which 4 hospitals in sub-Saharan Africa participated.

The Wilms Africa Phase I project showed improved end-of-treatment disease-free survival (68.5% vs 52%, P=0.002) and reduced treatment abandonment (12% vs 23%, P = 0.009). Two-year event free survival was 49.9%.

Wilms Africa Phase II started in January 2021, with the participation of seven hospitals in Malawi, Ethiopia, Ghana, Cameroon and Zimbabwe and using a revised and more comprehensive adapted treatment guideline.

Please find the most recent publication about the project and this overall improved survival of children with Wilms tumour here.

Please find a short video about the project and it’s impact here

Please find a short video of the presentation at the SIOP 2020 conference on the Wilms Africa by Dr Vivian Paintsil here (kindly create a CaseHippo user account to access the content free of charge)

Leadership

The Wilms Africa (Phase II) programme is led by Dr. Trijn Israels (Blantyre, Malawi), Chair and Principal Investigator (PI), Cecilia Mdoka (Blantyre, Malawi), Central Data Manager and Dr Vivian Paintsil (Kumasi, Ghana), Deputy-Chair. Prof Kathy Pritchard-Jones (London, UK and Previous Chair of the SIOP Renal Tumour Study Group and Previous SIOP President) is an advisor.

Dr. Trijn Israels

Blantyre, Malawi

Dr. Vivian Paintsil

Kumasi, Ghana

Participating Centers

Participating Centres

The Wilms tumour collaboration project is currently running in 8 centres in 5 sub-Saharan African countries. All participating centres have established Wilms tumour treatment. The project started in 2014. More than 300 patients have been included and treated.

Treatment Guidelines

Treatment Guidelines

A detailed treatment and study protocol was developed in March 2013 at a working group meeting in Malawi, following SIOP PODC guidelines. Collaborative Wilms Tumour Africa Treatment Guidelines Phase II are currently being updated, and will be launched in 2020.

Newsletters

Pictures and Videos

Trijn Israels: Collaborative Wilms Tumour Africa Project

Glenn Mbah: Collaborative Wilms Tumour Africa Project

Results, impact and publications

The Wilms Africa Phase I project showed improved end-of-treatment disease-free survival (68.5% vs 52%, P=0.002) and reduced treatment abandonment (12% vs 23%, P = 0.009). Two-year event free survival was 49.9% with treatment abandonment considered as an event.

Publications Wilms Africa Project

for further reading from the group

Israels T, Molyneux EM, Caron HN et al. Preoperative chemotherapy for patients with Wilms tumor in Malawi is feasible and efficacious. Pediatr Blood Cancer 2009.

Israels T, Borgstein E, de Kraker J, Molyneux EM. Acute malnutrition is common in Malawian patients with a Wilms tumour: A role for peanut butter. Pediatr Blood Cancer 2009.

Israels T, Damen CW, Boddy AV, Molyneux EM et al. Malnourished Malawian patients presenting with large Wilms tumours have a decreased vincristine clearance rate. Eur J Cancer 2010.

Israels T, Borgstein E, Pidini D, Chagaluka G, de Kraker J, Kamiza S et al. Management of children with a Wilms tumor in Malawi, sub-Saharan Africa. J Pediatr Hematol Oncol 2012.

Israels T, Chagaluka G, de Kraker J, Kamiza S et al. The efficacy and toxicity of SIOP preoperative chemotherapy in Malawian children with a Wilms tumour. Pediatr Blood Cancer 2012.

Israels T. Wilms tumor in Africa: challenges to cure. Highlight. Pediatr Blood Cancer 2012.

Israels T, Moreira C, Scanlan T et al. SIOP PODC: Clinical guidelines for the management of children with Wilms tumour in a low-income setting. Pediatr Blood Cancer. 2013;60(1):5-11.

Paintsil V, David H, Kambugu J et al. The Collaborative Wilms Tumour Africa Project; baseline evaluation of Wilms tumour treatment and outcome in eight institutes in sub-Saharan Africa. Eur J Cancer. 2015;51(1):84-91.

Israels T, Pidini D, Borgstein E et al. Survival of children with a Wilms tumor in Blantyre, Malawi. Pediatr Hematol Oncol. 2018;35(3):196-202.

Israels T, Paintsil V, Nyirenda D et al. Improved outcome at end of treatment in the collaborative Wilms tumour Africa project. Pediatr Blood Cancer 2018.

Chagaluka G, Paintsil V, Renner L. Improvement of overall survival in the Collaborative Wilms Tumour Africa Project. Pediatric Blood Cancer 2020.

Treatment guidelines

Please find here the link to multi-disciplinary, consensus adapted treatment guideline for Wilms Tumour and supportive care in low-income countries published in 2013. These guidelines are produced by a working group of the SIOP Committee for Pediatric Oncology in Developing Countries (PODC), in those years chaired by Dr Guillermo Chantada and Dr Trijn Israels.

Please find here the link to a more comprehensive and revised adapted treatment guideline for Wilms tumour in sub-Saharan Africa (and other low-income countries). This guideline is made available online on the SIOP website in 2020 and produced by the Wilms Africa group with input from multi-disciplinary experts from all over the world.

Both guidelines are widely used worldwide to guide clinicians in low-income countries regarding the treatment of children with Wilms tumour.

Collaborative Wilms Tumour Africa Project – Phase II (2021)

Phase II of the Collaborative Wilms Tumour Africa Project started in January 2021 and is implementing a revised and more comprehensive adapted treatment guideline. The revisions include guidance for radiotherapy (if available), optional longer postoperative chemotherapy and guidance for treatment of children with a relapse of disease.  The revised and comprehensive guideline can be found here.

Seven hospitals in Malawi, Ghana, Cameroon, Ethiopia and Zimbabwe are participating. All sites have local project and data managers with dedicated time, funded by grants from the SIOP Programme to Advance Research Capacity (SIOP PARC) and My Child Matters from Foundation S (previously Sanofi Espoir). Data collection has been >95% complete.

Contact

If you are interested and / or would like to support this initiative – please contact us at cancareafrica@gmail.com

Acknowledgement

​We are grateful for the funding from the Foundation S (My Child Matters) and the SIOP Board.

www.foundation-s.sanofi.com ww.siop-online.org