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Intracranial Orthotopic Allografting of Medulloblastoma Cells in Immunocompromised Mice

Intracranial Orthotopic Allografting of Medulloblastoma Cells in Immunocompromised Mice

Published on: October 3, 2010

Current medulloblastoma subgroup specific clinical trials.

Eric M Thompson^1,2,3,4, David Ashley^1,2,3, Daniel Landi^1,2,3

¹Department of Neurosurgery, Duke University, Durham, NC, USA.

Translational Pediatrics

|June 2, 2020

Summary

Current medulloblastoma clinical trials are exploring molecular subgroups, but treatments remain largely uniform, with craniospinal radiation dose as the primary variable. Future trials need novel agents to improve outcomes and reduce toxicity.

Keywords:

Group 3 Group 4 Medulloblastoma clinical trial sonic hedgehog (SHH)wingless (WNT)

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Area of Science:

Pediatric Oncology
Neuro-Oncology
Molecular Oncology

Background:

Medulloblastoma is a heterogeneous brain tumor with distinct molecular subgroups (WNT, SHH, Group 3, Group 4).
Progress in defining molecular drivers and prognostic factors for each subgroup has not yet translated into widespread risk stratification or treatment impact.
Limited clinical trials have incorporated molecular subgroup data to guide treatment strategies.

Purpose of the Study:

To provide an update on current clinical trials for medulloblastoma that utilize molecularly stratified treatment paradigms.
To assess the current landscape of clinical trials incorporating molecular subgroup information for newly diagnosed and recurrent medulloblastoma.

Main Methods:

A systematic search of ClinicalTrials.gov was performed using terms related to medulloblastoma and its molecular subgroups (WNT, SHH, Non-WNT/Non-SHH).
Identified trials were categorized based on disease status (newly diagnosed or recurrent) and treatment components.
Data on trial outcomes and specific molecular targets were reviewed.

Main Results:

Nine distinct clinical trials were identified: five for newly diagnosed and four for recurrent medulloblastoma.
Four newly diagnosed trials included craniospinal irradiation reduction for the WNT subgroup.
Trials for recurrent medulloblastoma primarily focused on the SHH subgroup, with limited data available.
A trial for WNT medulloblastoma using chemotherapy without radiation was closed due to early failures.
Phase II trials of vismodegib for SHH medulloblastoma showed disappointing results.

Conclusions:

While clinical trials are increasingly incorporating molecular data for medulloblastoma, current treatments are relatively uniform, mainly varying in craniospinal radiation dose.
Further research is needed to elucidate subgroup-specific drivers and prognoses.
Future clinical trials require novel targeted agents to improve patient outcomes and minimize treatment toxicity.