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\begin{document}

\title{Progress by international collaboration for pediatric renal tumors by
HARMONIsation and Collaboration: the HARMONICA initiative}



\author[1]{James Geller}%
\author[2]{Marry Van den Heuvel-Eibrink}%
\author[3]{Conrad Fernandez}%
\author[4]{Norbert Graf}%
\affil[1]{Cincinnati Children's Hospital Medical Center}%
\affil[2]{Prinses Maxima Centrum voor Kinderoncologie}%
\affil[3]{IWK Health Centre}%
\affil[4]{Krebsregister Saarland}%


\vspace{-1em}



  
  \date{May 27, 2024}


\begingroup
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\sloppy


\textbf{Introduction}

Since the initial attempts to treat children with renal cancer over 50
years ago, outcome for children with renal cancer has generally become
promising. While the first endeavors mainly included surgical treatment,
in the early 60s radiotherapy and chemotherapy were introduced, leading
to cure of patients, including some with metastatic disease. (1) Since
then, overall survival rates for the most common type of renal tumors in
childhood (nephroblastoma or Wilms tumor) have improved to more than 90
percent. These excellent treatment outcomes are similar in the 2 largest
clinical trial groups (the Children's Oncology Group Renal Tumor
Committee (COG-RTC; former National Wilms Tumor Study Group (NTWSG)),
and the International Society of Pediatric Oncology Renal Tumor Study
Group (SIOP-RTSG). Despite the difference in upfront treatment choice
(primary surgery when feasible (COG-RTC) or preoperative chemotherapy
(SIOP-RTSG)) both groups have optimized the stratification of patients
in their trials by modifying the intensity of treatment according to
individual risk factors, in order to improve outcome for high-risk renal
tumor types, but also to reduce early and late toxicity in lower and
intermediate risk tumors as much as possible. (2-4)

This improvement in risk stratification has resulted in better outcomes
and less cancer related toxicity. However, for remaining small subgroups
of pediatric renal tumor patients, with very poor outcomes, further
understanding of the underlying biology, in correlation with
clinic-pathological characteristics, is an unmet need. Further, standard
multidisciplinary treatment (surgery, radiotherapy, chemotherapy) can be
challenging to access and/or deliver in some low and middle income
countries (LMIC). The power inherent in international collaboration to
address these challenges was a driving principle that supported the
creation of the HARMONICA (HARMONIzation and COllaboration) initiative
in 2015, when we established an organized collaborative structure for
transatlantic experts from COG-RTC and SIOP-RTSG. The mandate of
HARMONICA is to identify specific challenges for pediatric renal tumor
subsets in order to meet the aims of our global approach to cure every
child with a renal tumor with limited toxicity.

The HARMONICA group meets at least once a month by videoconferences, and
as much as possible also face to face, at least once or twice a year,
during existing pediatric cancer conferences. In addition, several
transatlantic HARMONICA expert subgroups are collaborating on specific
topics. All work is currently done by a tremendous engagement of many
enthusiastic members of both study groups. Despite the fact of obvious
advantages, HARMONICA is still lacking funding and needs to optimize
their structure as a legal entity. Notwithstanding such limitations, in
this special issue of PBC, we present the achievements, the challenges,
and the future perspectives, identified by these expert groups.

\textbf{Achievements through international collaboration in pediatric
renal tumors}

Over the past decades, a focus on collaboration, rather than on
differences in approach, has opened the door for SIOP-RTSG and COG-RTC
to make translational steps on a global level towards better care. An
article of Giulio D'Angio, one of the pioneers in Pediatric Oncology,
addressed the question of pre- or postoperative therapy for Wilms' tumor
in 2008, when he wrote: ``SIOP participants, their North American
colleagues, and other investigators have conducted this debate in a
thoroughly collegial manner. Members of any study are welcome to attend
meetings of other groups, where advice and data are willingly
interchanged. The children have been the beneficiaries, as they should
be.'' (5) . It was again Giulio D'Angio, who stated that `'the
investigators have achieved what political and religious leaders have
not accomplished so far'', (6) after the very first joint publication,
in which data sets of children with renal tumors up to the age of 6
months were merged illustrating the benefits of such a collaborative
endeavor. (7) These early efforts led to a global `'surgery first''''
consensus for such young infants. A collaborative consensus guideline
for the management of adult Wilms tumors was developed as well, (8) as
was a meta-analysis on the potential role of high dose chemotherapy with
stem cell rescue for relapse Wilms tumor. (9) Targeting the IGF pathways
was summarized as a collaborate effort resulting from the SIOP/COG ENCCA
conference. (10) Intergroup mentoring of young investigators in the
field of molecular genetics of WT and CCSK revealed the molecular
landscape of DAWT, FHWT and CCSK through the TARGET initiative. (11-14)

More recently, during the HARMONICA era, coordinated parallel
manuscript/research efforts from COG/SIOP have focused on imaging
surveillance, (15, 16) stage 1 DAWT (17, 18) and WAGR and WT. (19, 20)
Collaborative reviews on unmet needs in WT, (21) addressing
international progress in WT, (3) WT phase 1 and 2 studies, (22)
congenital mesoblastic nephroma, (23) renal cell carcinoma (24) Wilms
tumor broadly, (25)) and more recently a comprehensive position paper on
oncofertility issues pertinent to pediatric renal cancer (26) have been
finalized.

Since the onset of HARMONICA, clinical outputs from such international
collaboration have produced practice changes in both cooperative groups.
The COG has adopted post-chemotherapy histology in patients with
bilateral Wilms tumor who undergo delayed nephrectomy, using
post-chemotherapy histologic risk criteria defined by SIOP. The SIOP has
adopted the COG approach to defining lung metastases and select
abdominal radiotherapy dosing guidelines for CCSK. Both groups have
adopted a harmonized definition to relapse Wilms risk classification,
based on upfront treatment intensity and histologic risk criteria. Such
advances only touch the surface of what is possible through data sharing
and meaningful open communication and dialogue.

\textbf{Challenging knowledge gaps}

For future progress, HARMONICA envisages to collaborate through
multidisciplinary activities on the levels of discipline groups and
panels. This organized collaborative structure for transatlantic experts
from COG-RTC and SIOP-RTSG aims to optimize progress for children with
renal tumors. Most important is to attract relevant stakeholders
including policy makers, parents and long-term survivors but also
funding agencies. This will allow attainment of knowledge and
achievement of goals by involving, recruiting, and exchanging talented
students and young investigators, and by including LMICs as partners,
for developing curative strategies. All this will further enhance access
of care for each child with renal cancer worldwide, which is also a goal
of SIOP and WHO. In effort to expedite such collaboration, we have
identified areas of research that could benefit from international
dialogue and collaboration and are the subject of a series of the 10
manuscripts that follow, each first authored by young investigators that
bring new ideas and fresh perspective into the field of pediatric renal
cancer. Briefly, the major themes explored in each of these manuscripts
is described below.

Epidemiological challenges, addressed by Libes et al, are not limited to
distinct database processes and definitions between the cooperative
groups and within the various LIMIC countries. Opportunities from
improved diagnostics, biobanking and integration of molecular testing
are discussed, as is the advantages of improved central review of
pathology and imaging. A global registration and data sharing initiative
concept is introduced.

Understanding the challenging definitions of nephrogenic rests
pathologically and radiographically, as well as nephroblastomatosis are
critical first steps before data sharing or comparative clinical trial
data can be advanced, is discussed by Fialkowski et al. Somewhat
related, Welter et al. address the pathophysiology of bilateral and
multifocal Wilms tumor and review renal tumor epigenetic and genetic
predisposition syndromes. Correlating biology with clinical parameters
including chemoresponse and survival outcomes including organ function
are likely to benefit from such ongoing international collaboration.

The field of tumor biomarkers, tumor heterogeneity, and the application
of liquid biopsy is tackled by Walz et al., wherein targeted
pre-clinical research and data sharing is highlighted as future
opportunities to ultimately inform treatment strategies and impact
patient outcomes. Hont et al. subsequently review key translational
aspects of pediatric renal tumor microenvironment and considerations for
potential immunotherapy.

Various similarities and controversies in renal tumor imaging between
the COG and SIOP are addressed by van der Beek et al. Future innovative
technologies and concepts, amenable to study optimally through
intergroup collaboration, are highlighted. Anatomic considerations are
further explored by Tracy et al. and a surgeon-oriented but
multidisciplinary group of authors wherein they share consensus opinions
regarding the limitations of partial nephrectomy and controversies
surrounding the approach to intravascular tumor extension. Technical
advances in the surgical management of Wilms tumor, focusing on future
directions and controversy of minimally invasive surgery, image guided
surgery and fluorescence-guided surgery, and optimization of the
surgical approach to lymph nodes are discussed by Romao et al.
Analogously, McAleer et al. review the consensus, controversies and
future directions of radiotherapy for Wilms tumor, noting knowledge gaps
and opportunities for future research in the areas of advanced
radiotherapy technologies including IMRT and proton beam therapy, the
impact of molecular markers on RT indications, mitigation of reduced
fertility through modulated radiation approaches, and promotion of
radiotherapy late effects research, much of which can be more optimally
advanced through international efforts.

In the final manuscript, Ortiz et al. address advances in the clinical
management of high-risk Wilms tumor. The shifting definition of `high
risk' and which patients that includes is addressed, accounting for
shifting outcomes and limited resources that can impact outcomes
greatly. Advancements in laboratory (biology, tumor model, drug
screening) and early phase clinical trials focusing on patients with
pediatric renal tumors is emphasized.

It is acknowledged that a key limitation of intergroup collaboration is
the discrepant upfront approach to patient management. The preferred
approach of randomized trials to address key advances is a challenge to
pursue via intergroup collaboration because of such global differences
in upfront treatment approaches. Regulatory and pharmaceutical industry
challenges are also present, especially for new agent trials, when
international multi-group smaller (patient number) trials are being
considered. Strategies may be available, however, to overcome these
potential barriers. For example, the COG RTC and SIOP RTSG also convened
to propose a similar chemotherapeutic backbone for children with
rhabdoid tumor, upon which different biologics would be added by the
different cooperative groups, obviating the need for complex new drug
trials combining cooperative groups, but enabling comparison of outcome
data. Through sharing of ideas, data, and research on an international
level, efforts like HARMONICA hold promise to move the pediatric renal
tumor field in the direction that benefits all children with renal
tumors globally. Nevertheless, access to such high-tech innovations and
molecular driven personalized treatment developments including advanced
and novel surgical and radiotherapeutic techniques need to be enhanced
in Low- and Middle-Income Countries (LMICs).

\textbf{References:}

\begin{enumerate}
\tightlist
\item
  Norbert Graf, Christophe Bergeron, Jesper Brok, Beatriz de Camargo,
  Tanzina Chowdhury, Rhoikos Furtw\selectlanguage{ngerman}ängler, Manfred Gessler, Jan
  Godzinski, Kathy Pritchard-Jones, Gema Ramirez, Christian Rübe, Bengt
  Sandstedt, Jens-Peter Schenk, Filippo Spreafico, Hélène
  Sudour-Bonnange, Harm van Tinteren, Arnauld Verschuur, Gordan Vujanic,
  Marry M. van den Heuvel-Eibrink. Fifty years of clinical and research
  studies for childhood renal tumors within the International Society of
  Pediatric Oncology (SIOP). Annals of Oncology 2021; doi:
  10.1016/j.annonc.2021.08.1749.
\item
  Dome Jeff S, Perlman Elizabeth J, Graf N: Risk stratification for
  wilms tumor: current approach and future directions. Am Soc Clin Oncol
  Educ Book 34:215-223, 2014.
\item
  Jeffrey S Dome, Graf N, James I. Geller, Conrad V Fernandez, Elizabeth
  A Mullen, Filippo Spreafico, Marry van den Heuvel-Eibrink, Kathy
  Pritchard-Jones: Advances in Wilms Tumor Treatment and Biology:
  Progress through international collaboration. J Clin Oncol
  33:2999-3007, 2015.
\item
  Marie V Nelson, Marry M van den Heuvel-Eibrink, Norbert Graf, Jeffrey
  S Dome: New approaches to risk stratification for Wilms tumor. Current
  Opinion Pediatr 2021, 33:40-48.
\item
  D'Angio GJ. Pre- or postoperative therapy for Wilms' tumor? J Clin
  Oncol. 2008 Sep 1;26(25):4055-7.
\item
  D'Angio GJ. Renal tumors in children: Challenges for developing
  countries and opportunities for collaboration. Ped Blood and Cancer
  2008; 50(6):1123-24.
\item
  van den Heuvel-Eibrink MM, Grundy P, Graf N, Pritchard-Jones K,
  Bergeron C, Patte C, Peter E, van Tinteren H, Rey A, Hutton C,
  Anderson JR, de Kraker J: Characteristics and Survival of 750 Children
  with a Renal Tumour in Infancy (0-6 months). A collaborative
  retrospective Study of the SIOP/GPOH/SFOP, NWTSG, and UK-CCSG. Pediatr
  Blood \& Cancer 50:1130-1134, 2008.
\item
  Segers H, van den Heuvel-Eibrink MM, Pritchard-Jones K, Coppes MJ,
  Aitchison M, Bergeron C, de Camargo B, Dome JS, Grundy P, Gatta G,
  Graf N, Grundy P, Kalapurakal JA, de Kraker J, Perlman EJ, Reinhard H,
  Spreafico F, Vujanic G, Warwick AB; SIOP-RTSG and the COG-Renal Tumour
  Committee. Management of adults with Wilms' tumor: recommendations
  based on international consensus. Expert Rev Anticancer Ther. 2011
  Jul;11(7):1105-13.
\item
  Ha TC, Spreafico F, Graf N, Dallorso S, Dome JS, Malogolowkin M,
  Furtwängler R, Hale JP, Moroz V, Machin D, Pritchard-Jones K. An
  international strategy to determine the role of high dose therapy in
  recurrent Wilms' tumour. Eur J Cancer. 2013 Jan;49(1):194-210.
\item
  Maschietto M, Charlton J, Perotti D, Radice P, Geller JI,
  Pritchard-Jones K, Weeks M. The IGF signalling pathway in Wilms
  tumours--a report from the ENCCA Renal Tumours Biology-driven drug
  development workshop. Oncotarget. 2014 Sep 30;5(18):8014-26.
\item
  Ooms AH, Gadd S, Gerhard DS, Smith MA, Guidry Auvil JM, Meerzaman D,
  Chen QR, Hsu CH, Yan C, Nguyen C, Hu Y, Ma Y, Zong Z, Mungall AJ,
  Moore RA, Marra MA, Huff V, Dome JS, Chi YY, Tian J, Geller JI,
  Mullighan CG, Ma J, Wheeler DA, Hampton OA, Walz AL, van den
  Heuvel-Eibrink MM, de Krijger RR, Ross N, Gastier-Foster JM, Perlman
  EJ. Significance of TP53 Mutation in Wilms Tumors with Diffuse
  Anaplasia: A Report from the Children's Oncology Group. Clin Cancer
  Res. 2016 Nov 15;22(22):5582-5591.
\item
  Walz AL, Ooms A, Gadd S, Gerhard DS, Smith MA, Guidry Auvil JM,
  Meerzaman D, Chen QR, Hsu CH, Yan C, Nguyen C, Hu Y, Bowlby R, Brooks
  D, Ma Y, Mungall AJ, Moore RA, Schein J, Marra MA, Huff V, Dome JS,
  Chi YY, Mullighan CG, Ma J, Wheeler DA, Hampton OA, Jafari N, Ross N,
  Gastier-Foster JM, Perlman EJ. Recurrent DGCR8, DROSHA, and SIX
  homeodomain mutations in favorable histology Wilms tumors. Cancer
  Cell. 2015 Feb 9;27(2):286-97.
\item
  Gadd S, Huff V, Walz AL, Ooms AHAG, Armstrong AE, Gerhard DS, Smith
  MA, Auvil JMG, Meerzaman D, Chen QR, Hsu CH, Yan C, Nguyen C, Hu Y,
  Hermida LC, Davidsen T, Gesuwan P, Ma Y, Zong Z, Mungall AJ, Moore RA,
  Marra MA, Dome JS, Mullighan CG, Ma J, Wheeler DA, Hampton OA, Ross N,
  Gastier-Foster JM, Arold ST, Perlman EJ. A Children's Oncology Group
  and TARGET initiative exploring the genetic landscape of Wilms tumor.
  Nat Genet. 2017 Oct;49(10):1487-1494.
\item
  Gooskens SL, Gadd S, Guidry Auvil JM, Gerhard DS, Khan J, Patidar R,
  Meerzaman D, Chen QR, Hsu CH, Yan C, Nguyen C, Hu Y, Mullighan CG, Ma
  J, Jennings LJ, de Krijger RR, van den Heuvel-Eibrink MM, Smith MA,
  Ross N, Gastier-Foster JM, Perlman EJ. TCF21 hypermethylation in
  genetically quiescent clear cell sarcoma of the kidney. Oncotarget.
  2015 Jun 30;6(18):15828-41.
\item
  Brok J, Lopez-Yurda M, Tinteren HV, Treger TD, Furtwängler R, Graf N,
  Bergeron C, van den Heuvel-Eibrink MM, Pritchard-Jones K, Olsen ØE, de
  Camargo B, Verschuur A, Spreafico F. Relapse of Wilms' tumour and
  detection methods: a retrospective analysis of the 2001 Renal Tumour
  Study Group-International Society of Paediatric Oncology Wilms' tumour
  protocol database. Lancet Oncol. 2018 Aug;19(8):1072-1081.
\item
  Mullen EA, Chi YY, Hibbitts E, Anderson JR, Steacy KJ, Geller JI,
  Green DM, Khanna G, Malogolowkin MH, Grundy PE, Fernandez CV, Dome JS.
  Impact of Surveillance Imaging Modality on Survival After Recurrence
  in Patients With Favorable-Histology Wilms Tumor: A Report From the
  Children's Oncology Group. J Clin Oncol. 2018 Oct
  18;36(34):JCO1800076.
\item
  Fajardo RD, van den Heuvel-Eibrink MM, van Tinteren H, Spreafico F,
  Acha T, Bergeron C, de Camargo B, Oldenburger F, Rübe C, Oue T, Vokuhl
  C, de Krijger RR, Vujanic G, Sebire N, Coulomb-L'Hermine A, Collini P,
  Gandola L, Pritchard-Jones K, Graf N, Janssens GO, van Grotel M. Is
  radiotherapy required in first-line treatment of stage I diffuse
  anaplastic Wilms tumor? A report of SIOP-RTSG, AIEOP, JWiTS, and
  UKCCSG. Pediatr Blood Cancer. 2020 Feb;67(2):e28039.
\item
  Daw NC, Chi YY, Kim Y, Mullen EA, Kalapurakal JA, Tian J, Khanna G,
  Geller JI, Perlman EJ, Ehrlich PF, Warwick AB, Grundy PE, Fernandez
  CV, Dome JS; AREN0321 Study Committee. Treatment of stage I anaplastic
  Wilms' tumour: a report from the Children's Oncology Group AREN0321
  study. Eur J Cancer. 2019 Sep;118:58-66.
\item
  Ehrlich PF, Chi YY, Chintagumpala MM, Hoffer FA, Perlman EJ,
  Kalapurakal JA, Tornwall B, Warwick A, Shamberger RC, Khanna G,
  Hamilton TE, Gow KW, Paulino AC, Gratias EJ, Mullen EA, Geller JI,
  Grundy PE, Fernandez CV, Dome JS. Results of Treatment for Patients
  With Multicentric or Bilaterally Predisposed Unilateral Wilms Tumor
  (AREN0534): A report from the Children's Oncology Group. Cancer. 2020
  Aug 1;126(15):3516-3525.
\item
  Hol JA, Jongmans MCJ, Sudour-Bonnange H, Ramírez-Villar GL, Chowdhury
  T, Rechnitzer C, Pal N, Schleiermacher G, Karow A, Kuiper RP, de
  Camargo B, Avcin S, Redzic D, Wachtel A, Segers H, Vujanic GM, van
  Tinteren H, Bergeron C, Pritchard-Jones K, Graf N, van den
  Heuvel-Eibrink MM; International Society of Pediatric Oncology Renal
  Tumor Study Group (SIOP-RTSG). Clinical characteristics and outcomes
  of children with WAGR syndrome and Wilms tumor and/or
  nephroblastomatosis: The 30-year SIOP-RTSG experience. Cancer. 2021
  Feb 15;127(4):628-638.
\item
  Brok J, Mavinkurve-Groothuis AMC, Drost J, Perotti D, Geller JI, Walz
  AL, Geoerger B, Pasqualini C, Verschuur A, Polanco A, Jones KP, van
  den Heuvel-Eibrink M, Graf N, Spreafico F. Unmet needs for relapsed or
  refractory Wilms tumour: Mapping the molecular features, exploring
  organoids and designing early phase trials - A collaborative
  SIOP-RTSG, COG~and ITCC session at the first SIOPE meeting. Eur J
  Cancer. 2021 Feb;144:113-122.
\item
  Brok J, Pritchard-Jones K, Geller JI, Spreafico F. Review of phase I
  and II trials for Wilms' tumour - Can we optimise the search for novel
  agents? Eur J Cancer. 2017 Jul;79:205-213.
\item
  Gooskens SL, Houwing ME, Vujanic GM, Dome JS, Diertens T,
  Coulomb-l'Herminé A, Godzinski J, Pritchard-Jones K, Graf N, van den
  Heuvel-Eibrink MM. Congenital mesoblastic nephroma 50 years after its
  recognition: A narrative review. Pediatr Blood Cancer. 2017 Jul;64(7).
\item
  van der Beek JN, Geller JI, de Krijger RR, Graf N, Pritchard-Jones K,
  Drost J, Verschuur AC, Murphy D, Ray S, Spreafico F, Dzhuma K,
  Littooij AS, Selle B, Tytgat GAM, van den Heuvel-Eibrink MM.
  Characteristics and Outcome of Children with Renal Cell Carcinoma: A
  Narrative Review. Cancers (Basel). 2020 Jul 3;12(7):1776.
\item
  Spreafico F, Fernandez CV, Brok J, Nakata K, Vujanic G, Geller JI,
  Gessler M, Maschietto M, Behjati S, Polanco A, Paintsil V,
  Luna-Fineman S, Pritchard-Jones K. Wilms tumour. Nat Rev Dis Primers.
  2021 Oct 14;7(1):75.
\item
  van der Perk MEM, Cost NG, Bos AME, Brannigan R, Chowdhury T, Davidoff
  AM, Daw NC, Dome JS, Ehrlich P, Graf N, Geller J, Kalapurakal J,
  Kieran K, Malek M, McAleer MF, Mullen E, Pater L, Polanco A, Romao R,
  Saltzman AF, Walz AL, Woods AD, van den Heuvel-Eibrink MM, Fernandez
  CV. White paper: Oncofertility in pediatric patients with Wilms tumor.
  Int J Cancer. 2022 Sep 15;151(6):843-858.
\end{enumerate}

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