Medulloblastoma: An old diagnosis with new promises Review
| Authors: | Szalontay, L.; Khakoo, Y. |
| Review Title: | Medulloblastoma: An old diagnosis with new promises |
| Abstract: | Purpose of Review: Molecular subtyping in medulloblastoma (MB) has diagnostic and prognostic values which impact therapy. This paper provides guidance for the clinician caring for pediatric and adult patients with medulloblastoma in the modern era. Recent Findings: Medulloblastoma comprises four molecularly distinct subgroups: wingless activated (WNT), sonic hedgehog activated (SHH), group 3, and group 4. Risk stratification before and after the discovery of molecular subgroups aims at minimizing toxicity by reducing radiation and chemotherapy doses in low-risk patients while maintaining favorable overall survival (OS). The mainstay of newly diagnosed medulloblastoma treatment is surgery, radiation therapy, and chemotherapy, except for children under 6 years of age, where high-dose chemotherapy with autologous stem cell rescue is used to avoid or delay radiotherapy, preventing neurocognitive sequelae. Management of recurrent/refractory medulloblastoma remains a challenge with immunotherapy and small-molecule inhibitors forming the backbone of novel strategies. Summary: Recent innovations in medulloblastoma research allow us to better understand pathogenesis and molecular characteristics resulting in advanced risk stratification models, new therapeutic approaches, and overall improved survival and quality of life. © 2020, Springer Science+Business Media, LLC, part of Springer Nature. |
| Keywords: | adult; cancer chemotherapy; child; gene mutation; overall survival; clinical feature; histopathology; pathogenesis; review; cisplatin; drug efficacy; drug safety; risk benefit analysis; gemcitabine; chemotherapy; cancer staging; nuclear magnetic resonance imaging; outcome assessment; neurosurgery; treatment indication; cancer immunotherapy; progression free survival; quality of life; computer assisted tomography; sonic hedgehog protein; alkylating agent; cyclophosphamide; vincristine; autologous stem cell transplantation; practice guideline; radiation injury; lomustine; central nervous system tumor; medulloblastoma; blood brain barrier; oncolytic virotherapy; genomics; radiation therapy; targeted therapy; cognitive defect; cancer classification; encephalitis; risk reduction; genetic predisposition; wnt protein; pemetrexed; meningitis; clinical trials; ototoxicity; central nervous system metastasis; g 207; myelitis; low risk patient; nivolumab; human; pembrolizumab; silmitasertib; molecular subtyping |
| Journal Title: | Current Oncology Reports |
| Volume: | 22 |
| Issue: | 9 |
| ISSN: | 1523-3790 |
| Publisher: | Springer |
| Date Published: | 2020-09-01 |
| Start Page: | 90 |
| Language: | English |
| DOI: | 10.1007/s11912-020-00953-4 |
| PUBMED: | 32643099 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Review -- Export Date: 3 August 2020 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work