Q&A: Dr. Brian Crompton, 2026 KCA Grant Winner

Dr. Brian Crompton received the 2026 Trailblazer Pediatric Renal Tumor Collaborative Impact Award given in partnership with the Kidney Cancer Association, Elevate Childhood Cancer Research and Advocacy, Wipe Out Wilms, and Joey’s Wings Foundation. Dr. Crompton’s research to “Detect, Diagnose, and Risk-Stratify by Liquid Biopsy in Pediatric Renal Tumors” proposed developing blood test to determine if cancer is present and what type it could be. He also hopes to find any high-risk features of Wilms tumors, the most common type of pediatric kidney cancer, so that children can be treated only as intensely as necessary. Dr. Crompton is the Research Co-Director of the Solid Tumor Center at Dana-Farber Cancer Institute as well as a physician and Associate Professor of Pediatrics at Harvard Medical School. We spoke with him about his research and the impact it can have on people with kidney cancer.

Describe your project and how you developed the idea.

Kidney tumors in children are not all the same disease. Some are aggressive and need intensive chemotherapy and others are easily treated, requiring little or no treatment. Today, the only reliable way to tell them apart is surgery or a biopsy, and both approaches carry risks, including spreading the tumor and removing a kidney that turns out to be healthy. Even after a child is diagnosed with Wilms tumor, the most common childhood kidney cancer, the high-risk features that guide treatment can be missed on a small piece of biopsy tissue.

All tumors shed tiny fragments of DNA into the blood. We are building a blood test (a “liquid biopsy”) that reads chemical marks and fragment patterns in that DNA. In Aim 1 of this project, the test will be developed to tell whether a child has a kidney cancer and which type, without surgery or a biopsy. In Aim 2, it will find high-risk features in Wilms tumor, so we can match treatment intensity for each child.

The idea grew out of a problem we see in the clinic. North American and European teams take opposite approaches to diagnosis, and each has their own risks and benefits. Our earlier work showed that tumor DNA can be detected in the blood of children with Wilms tumor and our early data show that a blood-based test can already tell two specific kidney cancers apart. 

What is the most exciting thing about your research for patients and families?

A simple blood draw could replace or delay invasive procedures. Fewer children would face surgery or biopsy just to learn what kind of tumor they have, and the risks of tumor spread and unnecessary kidney removal would drop. The same test could monitor children with genetic syndromes who have a high chance of developing a kidney tumor, catching cancer early when it is easier to treat. For children already diagnosed with Wilms tumor, it could help spare some from over-treatment and make sure others get the intensity they need.

What are the most challenging aspects of pediatric renal tumor research? Of pediatric cancer research, generally?

Kidney tumors are rare, and the rarest types are very rare, so it takes years and many institutions to collect enough samples. Diagnosis itself is hard, because imaging and small biopsies are often not accurate enough. Treatment approaches also differ between North America and Europe, which makes results harder to compare. Tumors can be heterogeneous, so one piece of tissue may not show the whole picture.

In pediatric cancer generally, small patient numbers limit studies and make technology development less attractive commercially. Funding is limited compared with adult cancers and promising diagnostic and prognostic tests require prospective validation in clinical trials before they can change care. All of these things make pediatric research more challenging than studies in more common adult cancers.

What could a major increase in research funding for pediatric cancer accomplish?

Funding would let us study collected samples much faster. We have already collected a larger cohort of samples from our institutional biobank and from a recent Children’s Oncology Group trial. With dedicated funding, we can profile and analyze them right away, which would speed up the path to prospective validation in future clinical trials. Without it, the work will still get done, but much more slowly than patients deserve.

Patients and families make this possible by donating samples and consenting to research, by joining clinical trials, and by advocating and giving, which funds work that traditional grant mechanisms rarely support. Our roles as researchers and clinicians include designing rigorous studies, sharing samples and data across institutions, turning lab findings into trials, and keeping families informed about what the results mean for them.

What motivates you?

Every child with cancer deserves a diagnosis and treatment that is as precise, effective, and as tolerable as possible. I’m motivated by the chance to spare children unnecessary surgery and chemotherapy, and to make sure the children who need more treatment get the correct therapy. In my own care of patients, I have seen challenges in obtaining diagnostic biopsy tissue result in months of incorrect treatment. These experiences and our liquid biopsy expertise, led directly to the conceptual design of this study. Our team is highly motivated to make this work successful and change the way diagnostics are conducted for patients with newly identified renal masses. 

What else do you want others to know about you or your research?

Our team is relentless and determined to make these technologies work for our patients. Our preliminary data is very promising. Together,  the patient samples in hand and funding form the KCA grant will accelerate our work, getting us closer to a clinical liquid biopsy test for patients. Ultimately, we hope that the technology we develop can be expanded to impact patients around the world, improving diagnostics for children in every region of the globe. I am also incredibly grateful to donors and advocates who have chosen to support this work and we are committed to making the most out of every dollar of funding that is supporting this project.