MYC and Wilms tumor: The high toxicity caused by Act-D is attributed to its ability to inhibit transcription of several important gene such as c-myc, c-met, myotonic Dystrophy type 1 etc. Importantly, it has been approved by the FDA for multiple tumors, Wilms’ tumor and gestational choriocarcinoma and in combination with other drugs to treat high risk tumor in chemotherapy regime [61–63].