SIOP PNET5 MB trial: history and concept of a molecularly stratified clinical trial of risk-adapted therapies for standard-risk medulloblastoma

Background. SIOP PNET5 MB was initiated in 2014 as the first European trial using clinical, histological, and molecular parameters to stratify treatments for children and adolescents with standard-risk medulloblastoma. Methods. Stratification by upfront assessment of molecular parameters requires th...

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Hauptverfasser: Mynarek, Martin (VerfasserIn) , Milde, Till (VerfasserIn) , Padovani, Laetitia (VerfasserIn) , Janssens, Geert O. (VerfasserIn) , Kwiecien, Robert (VerfasserIn) , Mosseri, Veronique (VerfasserIn) , Clifford, Steven C. (VerfasserIn) , Doz, François (VerfasserIn) , Rutkowski, Stefan (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2 December 2021
In: Cancers
Year: 2021, Jahrgang: 13, Heft: 23, Pages: 1-16
ISSN:2072-6694
DOI:10.3390/cancers13236077
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/cancers13236077
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2072-6694/13/23/6077
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Verfasserangaben:Martin Mynarek, Till Milde, Laetitia Padovani, Geert O. Janssens, Robert Kwiecien, Veronique Mosseri, Steven C. Clifford, François Doz and Stefan Rutkowski

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520 |a Background. SIOP PNET5 MB was initiated in 2014 as the first European trial using clinical, histological, and molecular parameters to stratify treatments for children and adolescents with standard-risk medulloblastoma. Methods. Stratification by upfront assessment of molecular parameters requires the timely submission of adequate tumour tissue. In the standard-risk phase-III cohort, defined by the absence of high-risk criteria (M0, R0), pathological (non-LCA), and molecular biomarkers (MYCN amplification in SHH-MB or MYC amplification), a randomized intensification by carboplatin concomitant with radiotherapy is investigated. In the LR stratum for localized WNT-activated medulloblastoma and age <16 years, a reduction of craniospinal radiotherapy dose to 18 Gy and a reduced maintenance chemotherapy are investigated. Two additional strata (WNT-HR, SHH-TP53) were implemented during the trial. Results. SIOP PNET5 MB is actively recruiting. The availability of adequate tumour tissue for upfront real-time biological assessments to assess inclusion criteria has proven feasible. Conclusion. SIOP PNET5 MB has demonstrated that implementation of biological parameters for stratification is feasible in a prospective multicentre setting, and may improve risk-adapted treatment. Comprehensive research studies may allow assessment of additional parameters, e.g., novel medulloblastoma subtypes, and identification and validation of biomarkers for the further refinement of risk-adapted treatment in the future. 
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