Medicine | Oncology
CNS tumors | Embryonal tumors

Medulloblastoma
Treatment


Home > Disciplines > Medicine > Oncology > CNS Tumors > Embryonal tumors > Medulloblastoma > Treatment


CONTENTS



OVERVIEW
EXTERNAL PAGE

LABORATORY INVESTIGATIONS
ESTROGEN AND SOY ISOFLAVONOIDS
VALPROIC ACID

CLINICAL INVESTIGATIONS

TUMOR VARIANTS AND SUBGROUPS
DESMOPLASTIC NODULAR MEDULLOBLASTOMA
MEDULLOBLASTOMA WITH EXTENSIVE NODULARITY

TREATMENT OPTIONS
ETOPOSIDE
RE-IRRADIATION
VINBLASTINE



Overview



Archer TC, Mahoney EL, Pomeroy SL.
Medulloblastoma: Molecular Classification-Based Personal Therapeutics.
Neurotherapeutics. 2017 Apr;14(2):265-273. doi: 10.1007/s13311-017-0526-y.
Source | Abstract | Full text | Similar articles




Collange NZ, Brito Sde A, Campos RR, Santos EA, Botelho RV; Sociedade Brasileira de Neurocirurgia.
Treatment of medulloblastoma in children and adolescents.
Rev Assoc Med Bras (1992). 2016 Jul;62(4):298-302. doi: 10.1590/1806-9282.62.04.298.
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Collange NZ, Brito Sde A, Campos RR, Santos EA, Botelho RV.
Treatment of medulloblastoma in children and adolescents. (FAQ)
Rev Assoc Med Bras (1992). 2016 Jul;62(4):297. doi: 10.1590/1806-9282.62.04.297.
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Frappaz D, Faure-Conter C, Bonneville Levard A, Barritault M, Meyronet D, Sunyach MP.
Medulloblastomas in adolescents and adults - Can the pediatric experience be extrapolated?
Neurochirurgie. 2018 Dec 17. pii: S0028-3770(18)30361-8. doi: 10.1016/j.neuchi.2018.10.007. [Epub ahead of print]
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Kumar V, Kumar V, McGuire T, Coulter DW, Sharp JG, Mahato RI.
Challenges and Recent Advances in Medulloblastoma Therapy.
Trends Pharmacol Sci. 2017 Oct 20. pii: S0165-6147(17)30181-5. doi: 10.1016/j.tips.2017.09.002. [Epub ahead of print]
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Sengupta S, Pomeranz Krummel D, Pomeroy S.
The evolution of medulloblastoma therapy to personalized medicine.
F1000Res. 2017 Apr 13;6:490. doi: 10.12688/f1000research.10859.1. eCollection 2017.
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RELAPSE IN MEDULLOBLASTOMA



Massimino M, Casanova M, Polastri D, Biassoni V, Modena P, Pecori E, Schiavello E, De Pava MV, Indini A, Rampini P, Bauer D, Catania S, Podda M, Gandola L.
Relapse in medulloblastoma: what can be done after abandoning high-dose chemotherapy? A mono-institutional experience.
Childs Nerv Syst. 2013 Jul;29(7):1107-12. doi: 10.1007/s00381-013-2104-x. Epub 2013 Apr 18.
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Laboratory investigations




OVERVIEW


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Nör C, Ramaswamy V.
Clinical and pre-clinical utility of genomics in medulloblastoma.
Expert Rev Neurother. 2018 Jul 26:1-15. doi: 10.1080/14737175.2018.1503536. [Epub ahead of print]
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Remke M, Ramaswamy V.
Infant medulloblastoma - learning new lessons from old strata.
Nat Rev Clin Oncol. 2018 Jul 20. doi: 10.1038/s41571-018-0071-6. [Epub ahead of print]
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ESTROGEN AND SOY ISOFLAVONOIDS



Belcher SM, Burton CC, Cookman CJ, Kirby M, Miranda GL, Saeed FO, Wray KE.
Estrogen and soy isoflavonoids decrease sensitivity of medulloblastoma and central nervous system primitive neuroectodermal tumor cells to chemotherapeutic cytotoxicity.
BMC Pharmacol Toxicol. 2017 Sep 6;18(1):63. doi: 10.1186/s40360-017-0160-7.
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VALPROIC ACID


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Mascaro-Cordeiro B, Oliveira ID, Tesser-Gamba F, Pavon LF, Saba-Silva N, Cavalheiro S, Dastoli P, Toledo SRC.
Valproic acid treatment response in vitro is determined by TP53 status in medulloblastoma.
Childs Nerv Syst. 2018 May 22. doi: 10.1007/s00381-018-3817-7. [Epub ahead of print]
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Clinical investigations




OVERVIEW



Bautista F, Fioravantti V, de Rojas T, Carceller F, Madero L, Lassaletta A, Moreno L.
Medulloblastoma in children and adolescents: a systematic review of contemporary phase I and II clinical trials and biology update.
Cancer Med. 2017 Oct 4. doi: 10.1002/cam4.1171. [Epub ahead of print]
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Lassaletta A.
Medulloblastoma in infants: the never-ending challenge.
Lancet Oncol. 2018 Jun;19(6):720-721. doi: 10.1016/S1470-2045(18)30278-X. Epub 2018 May 16.
Comment on: Robinson GW et al, Risk-adapted therapy for young children with medulloblastoma (SJYC07): therapeutic and molecular outcomes from a multicentre, phase 2 trial. Lancet Oncol. 2018 Jun;19(6):768-784.
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Robinson GW, Rudneva VA, Buchhalter I, Billups CA, Waszak SM, Smith KS, Bowers DC, Bendel A, Fisher PG, Partap S, Crawford JR, Hassall T, Indelicato DJ, Boop F, Klimo P, Sabin ND, Patay Z, Merchant TE, Stewart CF, Orr BA, Korbel JO, Jones DTW, Sharma T, Lichter P, Kool M, Korshunov A, Pfister SM, Gilbertson RJ, Sanders RP, Onar-Thomas A, Ellison DW, Gajjar A, Northcott PA.
Risk-adapted therapy for young children with medulloblastoma (SJYC07): therapeutic and molecular outcomes from a multicentre, phase 2 trial.
Lancet Oncol. 2018 Jun;19(6):768-784. doi: 10.1016/S1470-2045(18)30204-3. Epub 2018 May 16.
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CHEMOTHERAPY



Bonney PA, Santucci JA, Maurer AJ, Sughrue ME, McNall-Knapp RY, Battiste JD.
Dramatic response to temozolomide, irinotecan, and bevacizumab for recurrent medulloblastoma with widespread osseous metastases.
J Clin Neurosci. 2016 Apr;26:161-3. doi: 10.1016/j.jocn.2015.10.022. Epub 2016 Jan 14.
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Esbenshade AJ, Kocak M, Hershon L, Rousseau P, Decarie JC, Shaw S, Burger P, Friedman HS, Gajjar A, Moghrabi A.
A Phase II feasibility study of oral etoposide given concurrently with radiotherapy followed by dose intensive adjuvant chemotherapy for children with newly diagnosed high-risk medulloblastoma (protocol POG 9631): A report from the Children's Oncology Group.
Pediatr Blood Cancer. 2016 Dec 21. doi: 10.1002/pbc.26373. [Epub ahead of print]
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Gupta A, Kumar A, Abrari A, Patir R, Vaishya S.
Successful Use of Dose Dense Neoadjuvant Chemotherapy and Sodium Valproate with Minimal Toxicity in an Infant with Medulloblastoma in Extremely Poor General Condition.
World Neurosurg. 2016 Jul 20. pii: S1878-8750(16)30568-X. doi: 10.1016/j.wneu.2016.07.044. [Epub ahead of print]
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Kann BH, Lester-Coll NH, Park HS, Yeboa DN, Kelly JR, Baehring JM, Becker KP, Yu JB, Bindra RS, Roberts KB.
Adjuvant chemotherapy and overall survival in adult medulloblastoma.
Neuro Oncol. 2016 Aug 18. pii: now150. [Epub ahead of print]
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Lafay-Cousin L, Smith A, Chi SN, Wells E, Madden J, Margol A, Ramaswamy V, Finlay J, Taylor MD, Dhall G, Strother D, Kieran MW, Foreman NK, Packer RJ, Bouffet E.
Clinical, Pathological, and Molecular Characterization of Infant Medulloblastomas Treated with Sequential High-Dose Chemotherapy.
Pediatr Blood Cancer. 2016 Sep;63(9):1527-34. doi: 10.1002/pbc.26042. Epub 2016 May 4. Erratum in: Pediatr Blood Cancer. 2017 Apr;64(4).
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RADIOTHERAPY


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Chin AL, Moding EJ, Donaldson SS, Gibbs IC, Soltys SG, Hiniker SM, Pollom EL.
Survival Impact of Postoperative Radiotherapy Timing in Pediatric and Adolescent Medulloblastoma.
Neuro Oncol. 2018 Jan 4. doi: 10.1093/neuonc/noy001. [Epub ahead of print]
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Padovani L, Horan G, Ajithkumar T.
Radiotherapy Advances in Paediatric Medulloblastoma Treatment.
Clin Oncol (R Coll Radiol). 2019 Mar;31(3):171-181. doi: 10.1016/j.clon.2019.01.001. Epub 2019 Jan 14.
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Padovani L, Chapon F, André N, Boucekine M, Geoffray A, Bourdeau F, Masliah-Planchon J, Claude L, Huchet A, Laprie A, Supiot S, Coche-Dequéant B, Kerr C, Alapetite C, Leseur J, Nguyen T, Chapet S, Bernier V, Bondiau PY, Noel G, Habrand JL, Bolle S, Doz F, Dufour C, Muracciole X, Carrie C.
Hippocampal Sparing During Craniospinal Irradiation: What Did We Learn About the Incidence of Perihippocampus Metastases?
Int J Radiat Oncol Biol Phys. 2018 Mar 15;100(4):980-986. doi: 10.1016/j.ijrobp.2017.12.265. Epub 2017 Dec 21.
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Scobioala S, Parfitt R, Matulat P, Kittel C, Ebrahimi F, Wolters H, Am Zehnhoff-Dinnesen A, Eich HT.
Impact of radiation technique, radiation fraction dose, and total cisplatin dose on hearing : Retrospective analysis of 29 medulloblastoma patients.
Strahlenther Onkol. 2017 Sep 8. doi: 10.1007/s00066-017-1205-y. [Epub ahead of print]
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Tian S, Sudmeier LJ, Zhang C, Madden NA, Buchwald ZS, Shu HG, Curran WJ, Eaton BR, Esiashvili N.
Reduced-volume tumor-bed boost is not associated with inferior local control and survival outcomes in high-risk medulloblastoma.
Pediatr Blood Cancer. 2019 Oct 1:e28027. doi: 10.1002/pbc.28027. [Epub ahead of print]
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RADIO-CHEMOTHERAPY



Dagmar D, Proescholdt M, Reinert C, Pietsch T, Jones DTW, Pfister SM, Hattingen E, Seidel C, Dirven L, Luerding R, Reijneveld J, Warmuth-Metz M, Bonsanto M, Bremer M, Combs S, Rieken S, Herrlinger U, Kuntze H, Mayer-Steinacker R, Moskopp D, Schneider T, Beringer A, Schlegel U, Stummer W, Welker H, Weyerbrock A, Paulsen F, Rutkowski S, Weller M, Wick W, Kortmann RD, Bogdahn U, Hau P.
Multicenter pilot study of radio-chemotherapy as first-line treatment for adults with medulloblastoma (NOA-07).
Neuro Oncol. 2017 Aug 21. doi: 10.1093/neuonc/nox155. [Epub ahead of print]
Source | Abstract | Full text | Similar articles



SURGERY


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Goyal A, Cajigas I, Ibrahim GM, Brathwaite CD, Khatib Z, Niazi T, Bhatia S, Ragheb J.
Surgical Treatment of Intramedullary Spinal Metastasis in Medulloblastoma: Case Report and Review of the Literature.
World Neurosurg. 2018 Oct;118:42-46. doi: 10.1016/j.wneu.2018.06.250. Epub 2018 Jul 7.
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REOPERATION


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Patel P, Wallace D, Boop FA, Vaughn B, Robinson GW, Gajjar A, Klimo P Jr.
Reoperation for Medulloblastoma Prior to Adjuvant Therapy.
Neurosurgery. 2018 Apr 11. doi: 10.1093/neuros/nyy095. [Epub ahead of print]
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Recurrent tumors



Cefalo G, Massimino M, Ruggiero A, Barone G, Ridola V, Spreafico F, Potepan P, Abate ME, Mascarin M, Garrè ML, Perilongo G, Madon E, Colosimo C, Riccardi R.
Temozolomide is an active agent in children with recurrent medulloblastoma/primitive neuroectodermal tumor: an Italian multi-institutional phase II trial.
Neuro Oncol. 2014 May;16(5):748-53. doi: 10.1093/neuonc/not320. Epub 2014 Jan 30.
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Kameda-Smith MM, Wang A, Abdulhadi N, Voth R, Sergeant A, Maharaj A, Bakhshinyan D, Adile AA, Pai AM, Ajani O, Yarascavitch B, Alyman MC, Duckworth J, Samaan MC, Farrokhyar F, Singh SK, Fleming A; Pediatric Brain Tumour Study Group.
Salvage Therapy for Childhood Medulloblastoma: A Single Center Experience.
Can J Neurol Sci. 2019 Jul;46(4):403-414. doi: 10.1017/cjn.2019.39.
Source | Full text | Similar articles



RADIOTHERAPY



Burki TK.
Postoperative radiotherapy for paediatric medulloblastoma.
Lancet Oncol. 2016 Sep;17(9):e381. doi: 10.1016/S1470-2045(16)30390-4. Epub 2016 Aug 11.
Source | Abstract | Full text | Similar articles




Kann BH, Park HS, Lester-Coll NH, Yeboa DN, Benitez V, Khan AJ, Bindra RS, Marks AM, Roberts KB.
Postoperative Radiotherapy Patterns of Care and Survival Implications for Medulloblastoma in Young Children.
JAMA Oncol. 2016 Aug 4. doi: 10.1001/jamaoncol.2016.2547. [Epub ahead of print]
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Lannering B, Rutkowski S, Doz F, Pizer B, Gustafsson G, Navajas A, Massimino M, Reddingius R, Benesch M, Carrie C, Taylor R, Gandola L, Björk-Eriksson T, Giralt J, Oldenburger F, Pietsch T, Figarella-Branger D, Robson K, Forni M, Clifford SC, Warmuth-Metz M, von Hoff K, Faldum A, Mosseri V, Kortmann R.
Hyperfractionated versus conventional radiotherapy followed by chemotherapy in standard-risk medulloblastoma: results from the randomized multicenter HIT-SIOP PNET 4 trial.
J Clin Oncol. 2012 Sep 10;30(26):3187-93. doi: 10.1200/JCO.2011.39.8719. Epub 2012 Jul 30.
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CHEMOTHERAPY AND RADIOTHERAPY



Massimino M, Cefalo G, Riva D, Biassoni V, Spreafico F, Pecori E, Poggi G, Collini P, Pollo B, Valentini L, Potepan P, Seregni E, Casanova M, Ferrari A, Luksch R, Polastri D, Terenziani M, Pallotti F, Clerici CA, Schiavello E, Simonetti F, Meazza C, Catania S, Podda M, Gandola L.
Long-term results of combined preradiation chemotherapy and age-tailored radiotherapy doses for childhood medulloblastoma.
J Neurooncol. 2012 May;108(1):163-71. doi: 10.1007/s11060-012-0822-7. Epub 2012 Feb 16.
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GROWTH HORMONE REPLACEMENT THERAPY



Indini A, Schiavello E, Biassoni V, Bergamaschi L, Magni MC, Puma N, Chiaravalli S, Pallotti F, Seregni E, Diletto B, Pecori E, Gandola L, Poggi G, Massimino M.
Long-term safety of growth hormone replacement therapy after childhood medulloblastoma and PNET: it is time to set aside old concerns.
J Neurooncol. 2017 Jan;131(2):349-357. doi: 10.1007/s11060-016-2306-7. Epub 2016 Oct 21.
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METASTATIC MEDULLOBLASTOMA



von Bueren AO, Kortmann RD, von Hoff K, Friedrich C, Mynarek M, Müller K, Goschzik T, Zur Mühlen A, Gerber N, Warmuth-Metz M, Soerensen N, Deinlein F, Benesch M, Zwiener I, Kwiecien R, Faldum A, Bode U, Fleischhack G, Hovestadt V, Kool M, Jones D, Northcott P, Kuehl J, Pfister S, Pietsch T, Rutkowski S.
Treatment of Children and Adolescents With Metastatic Medulloblastoma and Prognostic Relevance of Clinical and Biologic Parameters.
J Clin Oncol. 2016 Dec;34(34):4151-4160. Epub 2016 Oct 31.
Source | Abstract | Full text | Similar articles



MILAN STRATEGY



Vivekanandan S, Breene R, Ramanujachar R, Traunecker H, Pizer B, Gaze MN, Saran F, Thorp N, English M, Wheeler K, Michalski A, Walker DA, Saunders D, Cowie F, Cameron A, Picton S, Parashar D, Horan G, Williams MV.
Reply to Comment on: The UK Experience of a Treatment Strategy for Pediatric Metastatic Medulloblastoma Comprising Intensive Induction Chemotherapy, Hyperfractionated Accelerated Radiotherapy, and Response-Directed High-Dose Myeloablative Chemotherapy or Maintenance Chemotherapy (Milan Strategy).
Pediatr Blood Cancer. 2016 Jun;63(6):1125-6. doi: 10.1002/pbc.25946. Epub 2016 Feb 17.
Source | Abstract | Full text | Similar articles




Massimino M, Spreafico F, Pignoli E, Gandola L.
Comment on: The UK Experience of a Treatment Strategy for Pediatric Metastatic Medulloblastoma Comprising Intensive Induction Chemotherapy, Hyperfractionated Accelerated Radiotherapy, and Response Directed High-Dose Myeloablative Chemotherapy or Maintenance Chemotherapy (Milan Strategy).
Pediatr Blood Cancer. 2016 Jun;63(6):1123-4. doi: 10.1002/pbc.25901. Epub 2016 Jan 14.
Source | Abstract | Full text | Similar articles




Vivekanandan S, Breene R, Ramanujachar R, Traunecker H, Pizer B, Gaze MN, Saran F, Thorp N, English M, Wheeler KA, Michalski A, Walker DA, Saunders D, Cowie F, Cameron A, Picton SV, Parashar D, Horan G, Williams MV.
The UK Experience of a Treatment Strategy for Pediatric Metastatic Medulloblastoma Comprising Intensive Induction Chemotherapy, Hyperfractionated Accelerated Radiotherapy and Response Directed High Dose Myeloablative Chemotherapy or Maintenance Chemotherapy (Milan Strategy).
Pediatr Blood Cancer. 2015 Dec;62(12):2132-9. doi: 10.1002/pbc.25663. Epub 2015 Aug 14.
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Gandola L, Massimino M, Cefalo G, Solero C, Spreafico F, Pecori E, Riva D, Collini P, Pignoli E, Giangaspero F, Luksch R, Berretta S, Poggi G, Biassoni V, Ferrari A, Pollo B, Favre C, Sardi I, Terenziani M, Fossati-Bellani F.
Hyperfractionated accelerated radiotherapy in the Milan strategy for metastatic medulloblastoma.
J Clin Oncol. 2009 Feb 1;27(4):566-71. doi: 10.1200/JCO.2008.18.4176. Epub 2008 Dec 15.
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SONIC HEDGEHOG INHIBITION



Kieran MW, Chisholm J, Casanova M, Brandes AA, Aerts I, Bouffet E, Bailey S, Leary S, MacDonald TJ, Mechinaud F, Cohen KJ, Riccardi R, Mason W, Hargrave D, Kalambakas S, Deshpande P, Tai F, Hurh E, Geoerger B.
Phase I study of oral sonidegib (LDE225) in pediatric brain and solid tumors and a phase II study in children and adults with relapsed medulloblastoma.
Neuro Oncol. 2017 Jun 9. doi: 10.1093/neuonc/nox109. [Epub ahead of print]
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Li Y, Song Q, Day BW.
Phase I and phase II sonidegib and vismodegib clinical trials for the treatment of paediatric and adult MB patients: a systemic review and meta-analysis.
Acta Neuropathol Commun. 2019 Jul 30;7(1):123. doi: 10.1186/s40478-019-0773-8.
Source . Similar articles




Lou E, Schomaker M, Wilson JD, Ahrens M, Dolan M, Nelson AC.
Complete and sustained response of adult medulloblastoma to first-line sonic hedgehog inhibition with vismodegib.
Cancer Biol Ther. 2016 Aug 12:1-7. [Epub ahead of print]
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Desmoplastic Nodular Medulloblastoma



AbdelBaki MS, Boué DR, Finlay JL, Kieran MW.
Desmoplastic Nodular Medulloblastoma in Young Children: A Management Dilemma.
Neuro Oncol. 2017 Nov 15. doi: 10.1093/neuonc/nox222. [Epub ahead of print]
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Medulloblastoma with extensive nodularity



Aristizabal P, Burns L, Rivera-Gomez R, Levy ML, Roberts W, Crawford JR.
Medulloblastoma With Extensive Nodularity: Tailored Therapy in a Low-resource Setting.
J Pediatr Hematol Oncol. 2017 Mar 6. doi: 10.1097/MPH.0000000000000798. [Epub ahead of print]

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