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Medulloblastoma | Treatment
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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.
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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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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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MB can be classified into four subgroups, each with different origins, pathogenesis, and potential therapeutic targets. miRNA and small-molecule targeted therapies have emerged as a potential new therapeutic paradigm in MB treatment. However, the development of chemoresistance due to surviving cancer stem cells and dysregulation of miRNAs remains a challenge. Combination therapies using multiple drugs and miRNAs could be effective approaches. In this review we discuss various MB subtypes, barriers, and novel therapeutic options which may be less toxic than current standard treatments.




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



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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Clinical investigations



OVERVIEWS



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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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



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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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]
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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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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.
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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.
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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.
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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.
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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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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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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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