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000178465 1001_ $$00000-0001-8405-2219$$aHill, Rebecca M$$b0
000178465 245__ $$aRelapsed Medulloblastoma in Pre-Irradiated Patients: Current Practice for Diagnostics and Treatment.
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000178465 520__ $$aRelapsed medulloblastoma (rMB) accounts for a considerable, and disproportionate amount of childhood cancer deaths. Recent advances have gone someway to characterising disease biology at relapse including second malignancies that often cannot be distinguished from relapse on imaging alone. Furthermore, there are now multiple international early-phase trials exploring drug-target matches across a range of high-risk/relapsed paediatric tumours. Despite these advances, treatment at relapse in pre-irradiated patients is typically non-curative and focuses on providing life-prolonging and symptom-modifying care that is tailored to the needs and wishes of the individual and their family. Here, we describe the current understanding of prognostic factors at disease relapse such as principal molecular group, adverse molecular biology, and timing of relapse. We provide an overview of the clinical diagnostic process including signs and symptoms, staging investigations, and molecular pathology, followed by a summary of treatment modalities and considerations. Finally, we summarise future directions to progress understanding of treatment resistance and the biological mechanisms underpinning early therapy-refractory and relapsed disease. These initiatives include development of comprehensive and collaborative molecular profiling approaches at relapse, liquid biopsies such as cerebrospinal fluid (CSF) as a biomarker of minimal residual disease (MRD), modelling strategies, and the use of primary tumour material for real-time drug screening approaches.
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000178465 650_7 $$2Other$$amedulloblastoma
000178465 650_7 $$2Other$$arelapse
000178465 7001_ $$aPlasschaert, Sabine L A$$b1
000178465 7001_ $$aTimmermann, Beate$$b2
000178465 7001_ $$00000-0001-5993-8077$$aDufour, Christelle$$b3
000178465 7001_ $$aAquilina, Kristian$$b4
000178465 7001_ $$aAvula, Shivaram$$b5
000178465 7001_ $$aDonovan, Laura$$b6
000178465 7001_ $$00000-0001-7488-1734$$aLequin, Maarten$$b7
000178465 7001_ $$aPietsch, Torsten$$b8
000178465 7001_ $$aThomale, Ulrich$$b9
000178465 7001_ $$aTippelt, Stephan$$b10
000178465 7001_ $$aWesseling, Pieter$$b11
000178465 7001_ $$aRutkowski, Stefan$$b12
000178465 7001_ $$aClifford, Steven C$$b13
000178465 7001_ $$0P:(DE-He78)f746aa965c4e1af518b016de3aaff5d9$$aPfister, Stefan M$$b14$$udkfz
000178465 7001_ $$00000-0003-4763-4329$$aBailey, Simon$$b15
000178465 7001_ $$00000-0001-5714-007X$$aFleischhack, Gudrun$$b16
000178465 773__ $$0PERI:(DE-600)2527080-1$$a10.3390/cancers14010126$$gVol. 14, no. 1, p. 126 -$$n1$$p126$$tCancers$$v14$$x2072-6694$$y2021
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