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Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Treatment Resistant Cancers02:56

Treatment Resistant Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Treatment Resistent Cancers02:56

Treatment Resistent Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Preclinical Development: Overview01:28

Preclinical Development: Overview

Preclinical development consists of a series of tests that ensure the safety and efficacy of a new therapeutic compound before it is tested in humans. There are four main phases to this process. First, safety pharmacology tests are conducted to ensure the drug does not produce any acutely harmful effects. These tests examine parameters such as bronchoconstriction, cardiac dysrhythmias, blood pressure changes, and ataxia. Next, preliminary toxicological testing is performed to determine the...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...

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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
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Paediatric therapeutic development workshop on medulloblastoma.

Claudia Montiel Equihua1, Joseph S Baxter1, Jan J Molenaar2

  • 1LifeArc, London, UK.

British Journal of Cancer
|July 9, 2026
PubMed
Summary

Developing new medulloblastoma therapies is crucial. The workshop prioritized targeting SRC, c-MYC/MYCN, and WNT pathways, alongside B7-H3 for CAR T-cell and ADC approaches, to improve survival and reduce side effects.

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Area of Science:

  • Pediatric Oncology
  • Cancer Therapeutics Development
  • Molecular Oncology

Background:

  • Medulloblastoma survival rates vary significantly by subtype, with high-risk groups facing poor prognoses (<10% survival).
  • Survivors of medulloblastoma often experience severe long-term side effects, highlighting the need for less toxic treatments.
  • Specific molecular subgroups, including SHH-medulloblastoma (MYCN amplified or TP53 mutated) and Group 3 medulloblastoma (c-MYC amplified), represent high-risk populations requiring targeted therapies.

Purpose of the Study:

  • To identify high-priority therapeutic strategies for medulloblastoma based on the Paediatric Therapeutic Development Workshop.
  • To outline innovative approaches for both poor-prognosis and good-prognosis medulloblastoma subtypes.
  • To guide the development of novel therapeutics and combination strategies to improve patient outcomes and reduce treatment toxicity.

Main Methods:

  • Consensus-based recommendations from the Paediatric Therapeutic Development Workshop on medulloblastoma.
  • Review of pre-clinical evidence and biological understanding to inform therapeutic development.
  • Discussion of potential combination therapies, including PARP-1, CHK1/2, CDK9, and ATR inhibitors.

Main Results:

  • High priority is placed on targeting SRC with degraders and inhibiting c-MYC/MYCN functions in poor-prognosis medulloblastoma.
  • An innovative approach involves using radiolabeled theranostic antibodies for WNT-medulloblastoma to reduce toxicity.
  • B7-H3 is identified as a promising target for CAR T-cell and Antibody-Drug Conjugate (ADC) therapies.

Conclusions:

  • Targeting specific molecular vulnerabilities in medulloblastoma subtypes is essential for improving survival.
  • Combination therapies, such as CNS-penetrant inhibitors, require rigorous pre-clinical evaluation before early-phase trials.
  • Future early-phase clinical studies should be international, incorporate novel designs for small patient cohorts, and integrate correlative biological studies.