Breaking News
February 18, 2019 - Breast cancer screening age should be lowered to 35
February 18, 2019 - Brain synchronization depends on the language of communication
February 18, 2019 - Drug Company Payments Over Time May Influence Rx Practices
February 18, 2019 - Despite socioeconomic gains, black-white ‘health gap’ remains
February 18, 2019 - Researchers report progress in the treatment of aggressive brain tumors
February 18, 2019 - Scientists discover trigger that turns strep infections into devastating disease
February 18, 2019 - Scanning children’s teeth may predict future mental health issues
February 18, 2019 - Health Highlights: Feb. 14, 2019
February 18, 2019 - New knowledge could help predict and prevent depression
February 18, 2019 - More primary care physicians leads to longer life spans | News Center
February 18, 2019 - Patented IU discovery to treat ARDS has been optioned to Theratome Bio
February 18, 2019 - Male Y chromosomes not ‘genetic wastelands’
February 18, 2019 - Hormone therapy during gender transition may increase risk for cardiovascular events
February 18, 2019 - NICE renews accreditation for Advanced
February 18, 2019 - FDA Grants Orphan Drug Designation to Amplyx Pharmaceuticals for APX001 for Treatment of Cryptococcosis
February 18, 2019 - Molecule effective in killing tuberculosis bacteria
February 18, 2019 - Columbia researchers unravel why some glioblastomas respond to immunotherapy
February 18, 2019 - Men who are able to do ten push-ups are less likely to have a stroke
February 18, 2019 - Blood-brain barrier disruption could lead to age-related cognitive decline
February 18, 2019 - Combination of PARP inhibitor and immunotherapy results in tumor regression in SCLC mouse models
February 18, 2019 - Heavy smoking could lead to vision loss, study finds
February 18, 2019 - New diagnostic test for malaria uses spit, not blood
February 18, 2019 - New therapeutic molecules show promise in reversing memory loss related to depression, aging
February 18, 2019 - Darla Shine joins anti-vaccination campaigners
February 18, 2019 - New study outlines sex-specific issues in ischemic heart disease
February 18, 2019 - Drug combinations could become first-line treatment for metastatic kidney cancer
February 18, 2019 - Lifetime adversity, increased neural processing during trauma combine to intensify core PTSD symptoms
February 18, 2019 - HRQoL Scores Decrease With Treatment Line in Multiple Myeloma
February 18, 2019 - Convincing evidence that type 2 diabetes is a cause of erectile dysfunction
February 18, 2019 - Study offers implications of advanced age in evaluation, management of ischemic heart disease
February 18, 2019 - Children from homes with flame-retardant sofa have high SVOC concentration in their blood
February 18, 2019 - Art Institute of Chicago announces results of research on five terracotta sculptures
February 18, 2019 - New PET/CT tracer shows high detection rate for diagnosis of acute venous thromboembolism
February 18, 2019 - Smoking may blight immune response against melanoma and reduce survival
February 18, 2019 - How Inactivity and Junk Food Can Harm Your Brain
February 18, 2019 - Diabetes tops common conditions for frequent geriatric emergency patients
February 18, 2019 - Longer-lived sperm produces offspring with healthier lifespans
February 18, 2019 - New dental adhesive prevents tooth decay around orthodontic brackets
February 18, 2019 - New eHealth tool shows potential to improve quality of asthma care
February 18, 2019 - New Australian initiative helps emergency clinicians to improve patient care
February 17, 2019 - Apellis Pharmaceuticals’ APL-2 Receives Fast Track Designation from the FDA for the Treatment of Patients with Paroxysmal Nocturnal Hemoglobinuria
February 17, 2019 - Researchers identify faulty ‘brake’ that interferes with heart muscle’s ability to contract and relax
February 17, 2019 - Support from trusted adults can reduce risk of dying in suicidal teens, finds study
February 17, 2019 - Heart attack awareness improved since 2008
February 17, 2019 - Exercise gives a better brain boost to older men than women
February 17, 2019 - New research disproves previous assumptions of how looks influence personality
February 17, 2019 - Cannabis use as a teenager linked to depression later in life
February 17, 2019 - Sinks by Toilets in ICU Patient Rooms Harbor Harmful Bacteria
February 17, 2019 - Cancer cells’ plasticity makes them harder to stop
February 17, 2019 - Young cannabis users have increased risk of depression and suicidal behavior
February 17, 2019 - Tasmanian Devils Likely to Survive Cancer Scourge
February 17, 2019 - Neoadjuvant PD-1 blockade seems effective in glioblastoma
February 17, 2019 - Personal, social factors play role in enabling sustainable return to work after ill health
February 17, 2019 - Mouse studies show ‘inhibition’ theory of autism wrong
February 17, 2019 - Study shows how neuroactive steroids inhibit activity of pro-inflammatory proteins
February 17, 2019 - Use of liver grafts from older donors decreased despite better outcomes in recipients
February 17, 2019 - MUSC researchers discover new mechanism for a class of anti-cancer drugs
February 17, 2019 - HPV misconceptions are causing women to miss smear tests
February 17, 2019 - Sanofi and Regeneron Offer Praluent (alirocumab) at a New Reduced U.S. List Price
February 17, 2019 - Researchers say auditory testing can identify children for autism screening
February 17, 2019 - New method analyzes how single biological cells react to stressful situations
February 17, 2019 - WVU gynecologic oncologist investigates novel treatment for cervical and vaginal cancers
February 17, 2019 - ADHD diagnoses poorly documented
February 17, 2019 - Majority of gender minority youth do not identify with traditional sexual identity labels
February 17, 2019 - AbbVie, Teneobio enter into strategic transaction to develop potential treatment for multiple myeloma
February 17, 2019 - Lower Birth Weight May Up Risk for Psychiatric Disorders
February 17, 2019 - Scientists identify reversible molecular defect underlying rheumatoid arthritis
February 17, 2019 - Moffitt researchers shed light on how CAR T cells function mechanistically
February 16, 2019 - Female Anatomy May Play Big Role in Sperm’s Success
February 16, 2019 - BMI may mediate inverse link between fiber intake, knee OA
February 16, 2019 - Movement impairments in autism can be reversed through behavioral training
February 16, 2019 - Studies address racial disparities in postpartum period and cardiovascular health
February 16, 2019 - Scientists implicate hidden genes in the severity of autism symptoms
February 16, 2019 - Decreased deep sleep linked to early signs of Alzheimer’s disease
February 16, 2019 - Neuroscientists show how the brain responds to texture
February 16, 2019 - Gilead Announces Topline Data From Phase 3 STELLAR-4 Study of Selonsertib in Compensated Cirrhosis (F4) Due to Nonalcoholic Steatohepatitis (NASH)
February 16, 2019 - What Can I Do About Sweating? (for Teens)
February 16, 2019 - Companies navigate dementia conversations with older workers
February 16, 2019 - Newly developed stem cell technologies show promise for treating PD patients
February 16, 2019 - Collaborative material research could advance self-assembling nanomaterials
Researchers discover medulloblastoma subtype that responds to less aggressive therapy

Researchers discover medulloblastoma subtype that responds to less aggressive therapy

image_pdfDownload PDFimage_print

The youngest patients with the brain tumor medulloblastoma are among the most challenging because their rapidly developing brains limit treatment options. Now a team of researchers led by St. Jude Children’s Research Hospital have discovered a subtype that responds to a therapy that is less likely to cause long-term cognitive problems.

The report appears today in the journal Lancet Oncology and sets the stage for screening medulloblastoma patients to identify those with the subtype.

“This study has important ramifications for treatment of young children with medulloblastoma, a group whose long-term survival rates are stalled at about 50 percent and progression-free survival remains even lower,” said first and corresponding author Giles Robinson, M.D., an assistant member of the St. Jude Department of Oncology. “Combination therapy with radiation and chemotherapy has increased survival rates of older children and adolescents, but radiation toxicity has limited its use in younger patients, particularly those less than 3 years old. “Now we have identified a subtype of medulloblastoma that accounts for about 25 percent of infant medulloblastoma and that can be treated successfully with reduced-intensity chemotherapy,” Robinson said.

Seventy-five percent of the 21 patients in the newly identified subtype were alive five years after their diagnosis, and their disease had not worsened (progressed). The rates were even better, 91 percent, for the low-risk patients whose tumor had been completely surgically removed and had not spread.

Medulloblastoma is the most common malignant childhood brain tumor and one of the leading causes of non-accidental death in U.S. children and adolescents. The tumor includes four main molecular subgroups–WNT, sonic hedgehog (SHH), group 3, group 4–each with different clinical and biological characteristics as well as treatment outcomes.

The tumor is diagnosed in about 400 U.S. residents annually, mostly in individuals under 16 years old. With current treatment, which includes surgery, whole-brain and spine irradiation, and chemotherapy, about 70 percent of patients are alive five years after diagnosis. However, brain and spine radiation therapy can be particularly damaging to the developing brain. But long-term survival remains about 50 percent or less when radiation therapy is omitted, reduced or delayed.

The new medulloblastoma subtype is infant SHH-II. It was discovered in a subset of patients with SHH medulloblastoma. The patients were enrolled in a St. Jude-led, 10-year, multi-center phase II clinical trial of risk-adapted therapy for treatment of medulloblastoma patients age 5 and younger. Of the 81 patients enrolled, 65, or 80 percent, were younger than age 3 and were classified as infants.

Patients were assigned to low, intermediate or high-risk therapy based on clinical factors and tumor histology (how tumors looked under the microscope). All patients were treated with chemotherapy. Radiation therapy was limited to intermediate-risk patients who received focal radiation of the tumor bed, not irradiation of the whole brain and spine. No patients received myeloablative regimens that required stem cell transplantation or intrathecal chemotherapy (chemotherapy injected into cerebrospinal fluid).

Researchers used next-generation genomic sequencing and DNA methylation patterns to analyze treatment response based on the patients’ molecular subgroups. DNA methylation refers to chemical compounds called methyl groups that attach to DNA and serve as on-off switches to regulate gene expression.

Overall, researchers reported that risk-adapted therapy did not improve progression-free survival. However, analysis of the DNA methylation data revealed distinct subgroups and subtypes of medulloblastoma that were associated with distinct outcomes. First, the researchers noticed that patients with SHH medulloblastoma had higher rates of progression-free survival compared to patients with group 3 or group 4 medulloblastoma. Even more revealing was that the 42 SHH patients evenly divided between subtypes that researchers called iSHH-I and iSHH-II.

Patients with the iSHH-II subtype were less likely to have their disease worsen or return after therapy. The patients were also more likely to survive at least five years when compared to patients with iSHH-I or with group 3 or 4 medulloblastoma.

“While we’ve understood for some time that medulloblastoma is not a single disease, the results of this molecular analysis are a humbling reminder of differences within medulloblastoma subgroups that influence treatment response,” Robinson said. “That is important to keep in mind as the next generation of molecularly driven therapies are designed.”

About author

Related Articles