Collaboration in international clinical trials, improvement of multimodal therapy and risk stratification strategies have led to improved outcome for children with Wilms tumour (WT). In children with WT where cure rates are high it is critical that the balance of risk and benefit of treatment continues to be optimised through further fine tuning of risk stratification strategies that determine which children need more intensive therapy and those that can do with less. Work in the field of genetics and epigenetics is pointing towards common signalling pathways, dysregulation of the epigenome and the identification of gene expression profile subsets in children with WT that will direct future research into targeted therapies and enable better predictions of tumour sensitivity to therapy and recurrence.
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