Pattern of Relapse and Treatment Response in WNT-Activated Medulloblastoma.
Cell Rep Med
; 1(3)2020 06 23.
Article
en En
| MEDLINE
| ID: mdl-32743560
ABSTRACT
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.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Protocolos de Quimioterapia Combinada Antineoplásica
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Neoplasias Cerebelosas
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Meduloblastoma
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Recurrencia Local de Neoplasia
Límite:
Adolescent
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Child
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Cell Rep Med
Año:
2020
Tipo del documento:
Article
País de afiliación:
Canadá