| Title: |
Pattern of Relapse and Treatment Response in WNT-Activated Medulloblastoma |
| Authors: |
Nobre, L; Zapotocky, M; Khan, S; Fukuoka, K; Fonseca, A; McKeown, T; Sumerauer, D; Vicha, A; Grajkowska, WA; Trubicka, J; Li, KKW; Ng, HK; Massimi, L; Lee, JY; Kim, SK; Zelcer, S; Vasiljevic, A; Faure-Conter, C; Hauser, P; Lach, B; van Veelen-Vincent, ML; French, PJ; Van Meir, EG; Weiss, WA; Gupta, N; Pollack, IF; Hamilton, RL; Nageswara Rao, AA; Giannini, C; Rubin, JB; Moore, AS; Chambless, LB; Vibhakar, R; Ra, YS; Massimino, M; McLendon, RE; Wheeler, H; Zollo, M; Ferruci, V; Kumabe, T; Faria, CC; Sterba, J; Jung, S; López-Aguilar, E; Mora, J; Carlotti, CG; Olson, JM; Leary, S; Cain, J; Krskova, L; Zamecnik, J; Hawkins, CE; Tabori, U; Huang, A; Bartels, U; Northcott, PA; Taylor, MD; Yip, S; Hansford, JR; Bouffet, E; Ramaswamy, V |
| Publisher Information: |
CELL PRESS |
| Publication Year: |
2020 |
| Collection: |
The University of Melbourne: Digital Repository |
| Description: |
Over the past decade, wingless-activated (WNT) medulloblastoma has been identified as a candidate for therapy de-escalation based on excellent survival; however, a paucity of relapses has precluded additional analyses of markers of relapse. To address this gap in knowledge, an international cohort of 93 molecularly confirmed WNT MB was assembled, where 5-year progression-free survival is 0.84 (95%, 0.763-0.925) with 15 relapsed individuals identified. Maintenance chemotherapy is identified as a strong predictor of relapse, with individuals receiving high doses of cyclophosphamide or ifosphamide having only one very late molecularly confirmed relapse (p = 0.032). The anatomical location of recurrence is metastatic in 12 of 15 relapses, with 8 of 12 metastatic relapses in the lateral ventricles. Maintenance chemotherapy, specifically cumulative cyclophosphamide doses, is a significant predictor of relapse across WNT MB. Future efforts to de-escalate therapy need to carefully consider not only the radiation dose but also the chemotherapy regimen and the propensity for metastatic relapses. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
2666-3791 |
| Relation: |
pii: 100038; https://hdl.handle.net/11343/245146 |
| Availability: |
https://hdl.handle.net/11343/245146 |
| Rights: |
https://creativecommons.org/licenses/by-nc-nd/4.0 ; CC BY-NC-ND |
| Accession Number: |
edsbas.20F35BBD |
| Database: |
BASE |