Review
Oncology
E. Franceschi, C. Seidel, F. Sahm, K. W. Pajtler, P. Hau
Summary: Medulloblastoma is a rare tumor in postpubertal patients and adults, with different subtypes having distinct prognoses and offering personalized treatment options. While multimodal therapies have shown good overall survival rates, therapeutic evidence from prospective randomized trials in adults is lacking. Treatment typically involves craniospinal chemoradiation followed by maintenance chemotherapy, with targeted therapies not yet widely implemented but showing promise for personalized approaches, particularly in the SHH subgroup. Regular clinical follow-up and monitoring are crucial for managing relapse and ensuring optimal outcomes for patients.
Article
Oncology
Erin S. Murphy, Girish Dhall, Jason Fangusaro, Ute Bartels, Maryam Fouladi, Dennis Shaw, Soumen Khatua, Chris Williams Hughes, Ashok Panigraphy, Myrsini Ioakeim-Ioannidou, Mark Souweidane, David Morris, Amar Gajjar, Shengjie Wu, Arzu Onar-Thomas, Daphne A. Haas-Kogan, Shannon M. MacDonald
Summary: This study aimed to evaluate the efficacy of reduced dose and field of radiation therapy in patients with localized NGGCT who achieved a complete or partial response to chemotherapy. The results suggest that the spine is at risk for recurrence in these patients. The quality of radiation therapy was high, and providing visual guidance in the form of an online atlas had a positive impact on treatment planning.
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
(2022)
Article
Oncology
Sujith Baliga, Lorenza Gandola, Beate Timmermann, Horan Gail, Laetitia Padovani, Geert O. Janssens, Torunn Yock
Summary: Children with medulloblastoma, ATRT, and ependymoma are treated with a multidisciplinary approach involving surgery, radiotherapy, and chemotherapy. Treatment strategies are tailored based on risk groups to optimize cure rates and minimize long-term complications. Proton therapy shows promise in reducing neurocognitive and endocrine complications compared to photons.
PEDIATRIC BLOOD & CANCER
(2021)
Review
Pharmacology & Pharmacy
Claire O. Kisamore, Brittany D. Elliott, A. Courtney Devries, Randy J. Nelson, William H. Walker II
Summary: Circadian rhythms are internal manifestations of the 24-h solar day that synchronize biological and behavioral processes to improve adaptive function and survival. Chronotherapy optimizes drug administration based on circadian rhythms to achieve maximum therapeutic efficacy and minimize side effects. This review examines the evidence for chronotherapeutic treatment for solid tumors, including chrono-chemotherapy, chrono-radiotherapy, and alternative chronotherapeutics, and discusses areas for further research and challenges in the field.
Article
Oncology
Anthony P. Y. Liu, Kyle S. Smith, Rahul Kumar, Leena Paul, Laure Bihannic, Tong Lin, Kendra K. Maass, Kristian W. Pajtler, Murali Chintagumpala, Jack M. Su, Eric Bouffet, Michael J. Fisher, Sridharan Gururangan, Richard Cohn, Tim Hassall, Jordan R. Hansford, Paul Klimo, Frederick A. Boop, Clinton F. Stewart, Julie H. Harreld, Thomas E. Merchant, Ruth G. Tatevossian, Geoffrey Neale, Matthew Lear, Jeffery M. Klco, Brent A. Orr, David W. Ellison, Richard J. Gilbertson, Arzu Onar-Thomas, Amar Gajjar, Giles W. Robinson, Paul A. Northcott
Summary: The study demonstrates the clinical utility of CSF-derived cell-free DNA (cfDNA) as a biomarker of measurable residual disease (MRD) in children with medulloblastoma. Detection of MRD, particularly in patients with persistent MRD, is associated with a higher risk of disease progression. Early detection of MRD using liquid biopsies may aid in monitoring disease progression and treatment efficacy in medulloblastoma patients.
Article
Oncology
Chonnipa Nantavithya, Arnold C. Paulino, Kaiping Liao, Kristina D. Woodhouse, Susan L. McGovern, David R. Grosshans, Mary F. McAleer, Soumen Khatua, Murali M. Chintagumpala, Nazanin Majd, Wafik Zaky, Debra N. Yeboa
Summary: The study found that patients with medulloblastoma are at elevated risk for second malignant neoplasms (SMNs) compared to the general population. Variations in observed-to-expected incidence ratios for SMNs by organ systems were influenced by treatment modality, age at diagnosis, and time of diagnosis.
Article
Oncology
Tejpal Gupta, Shizan Pervez, Archya Dasgupta, Abhishek Chatterjee, Sridhar Epari, Girish Chinnaswamy, Rakesh Jalali
Summary: This study assessed the safety of avoiding upfront craniospinal irradiation in children with low-risk WNT-pathway medulloblastoma. The results showed an unacceptably high risk of neuraxial failure, suggesting that this approach is not safe.
CLINICAL CANCER RESEARCH
(2022)
Review
Oncology
Kevin Beccaria, Laetitia Padovani, Yassine Bouchoucha, Francois Doz
Summary: The review highlights the importance of the new biopathological classification of medulloblastoma subtypes on therapeutic indications, emphasizing a multidisciplinary approach including surgery, radiation oncology, and medical treatments. It also discusses recent technical improvements in neurosurgery and radiotherapy, as well as adaptation of medical treatments based on age and risk factors. Referral to specialized centers for diagnosis, biopathological subtyping, and treatment is justified due to the rarity of the disease and high level of technicity involved.
CURRENT OPINION IN ONCOLOGY
(2021)
Review
Neurosciences
Bo Zhang, Hao Zhang, Zeyu Wang, Hui Cao, Nan Zhang, Ziyu Dai, Xisong Liang, Yun Peng, Jie Wen, Xun Zhang, Liyang Zhang, Peng Luo, Jian Zhang, Zaoqu Liu, Quan Cheng, Renjun Peng
Summary: CircRNA are increasingly proven to participate in the development of CNS tumors. An in-depth study of the causal mechanisms of circRNAs in CNS tumor progression will ultimately advance their implementation in the clinic and develop new strategies for preventing and treating CNS tumors.
CNS NEUROSCIENCE & THERAPEUTICS
(2023)
Article
Oncology
Amar Gajjar, Giles W. Robinson, Kyle S. Smith, Tong Lin, Thomas E. Merchant, Murali Chintagumpala, Anita Mahajan, Jack Su, Eric Bouffet, Ute Bartels, Tal Schechter, Tim Hassall, Thomas Robertson, Wayne Nicholls, Sridharan Gururangan, Kristin Schroeder, Michael Sullivan, Greg Wheeler, Jordan R. Hansford, Stewart J. Kellie, Geoffrey McCowage, Richard Cohn, Michael J. Fisher, Matthew J. Krasin, Clinton F. Stewart, Alberto Broniscer, Ivo Buchhalter, Ruth G. Tatevossian, Brent A. Orr, Geoff Neale, Paul Klimo, Frederick Boop, Ashok Srinivasan, Stefan M. Pfister, Richard J. Gilbertson, Arzu Onar-Thomas, David W. Ellison, Paul A. Northcott
Summary: The study identified new risk stratification for medulloblastoma treatment through molecular classification and risk factor analysis, finding differences in PFS among patients with different genotypes and subtypes.
JOURNAL OF CLINICAL ONCOLOGY
(2021)
Editorial Material
Oncology
Marc Remke, Vijay Ramaswamy
Summary: This article discusses the treatment of pediatric medulloblastoma and highlights the substantial long-term sequelae despite improved survival rates. It raises the question of how to safely de-escalate therapy without compromising its effectiveness.
CLINICAL CANCER RESEARCH
(2022)
Article
Oncology
Yirui Zhai, Qiang Zeng, Nan Bi, Zongmei Zhou, Zefen Xiao, Zhouguang Hui, Dongfu Chen, Luhua Wang, Jianyang Wang, Wenyang Liu, Lei Deng, Jima Lv, Wenqing Wang, Yang Luo, Junling Li, Xin Wang, Tao Zhang, Yushun Gao, Qinfu Feng
Summary: Thymic neuroendocrine tumors (TNETs) are rare and aggressive, with a high recurrence rate even in typical carcinoid tumors. Surgical resection is the main treatment, however, combination therapy including chemotherapy and radiotherapy is necessary to improve the treatment outcome. Patients with large vessel invasion have a poor prognosis and alternative therapeutic approaches should be explored.
Article
Oncology
Linan Song, Shuo Wang, Tong Fang, Xiaoguang Qiu, Xiaoli Wang, Xinna Zhou, Michael A. Morse, Amy Hobeika, Wanshui Wu, Huabing Yang, Jun Ren, Herbert Kim Lyerly
Summary: The study found that changes in peripheral blood T lymphocyte subsets and cytokines during radiation therapy for pediatric brain tumors are associated with therapeutic outcomes. In patients receiving craniospinal irradiation (CSI), the post/pre-RT ratios of Tregs, IL-6, and IL-10 were independent predictors of complete response (CR).
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
(2021)
Review
Oncology
Enrico Franceschi, Caterina Giannini, Julia Furtner, Kristian W. Pajtler, Sofia Asioli, Raphael Guzman, Clemens Seidel, Lidia Gatto, Peter Hau
Summary: Adult medulloblastoma is a rare tumor of the central nervous system with treatment primarily based on pediatric experience. Novel molecular advances and hub centers play a crucial role in improving the overall outcome of this disease.
Article
Oncology
Arnold C. Paulino, Ethan B. Ludmir, David R. Grosshans, Jack M. Su, Susan L. McGovern, M. Fatih Okcu, Mary Frances McAleer, Patricia A. Baxter, Anita Mahajan, Murali M. Chintagumpala
Summary: The study compared the incidence of secondary malignant neoplasm in children with medulloblastoma treated with photon CSI and intensity-modulated RT boost versus passively scattered proton CSI and boost, showing no significant difference in overall survival or secondary malignant neoplasm incidence rates between the two groups.