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@ARTICLE{Hill:178465,
      author       = {R. M. Hill and S. L. A. Plasschaert and B. Timmermann and
                      C. Dufour and K. Aquilina and S. Avula and L. Donovan and M.
                      Lequin and T. Pietsch and U. Thomale and S. Tippelt and P.
                      Wesseling and S. Rutkowski and S. C. Clifford and S. M.
                      Pfister$^*$ and S. Bailey and G. Fleischhack},
      title        = {{R}elapsed {M}edulloblastoma in {P}re-{I}rradiated
                      {P}atients: {C}urrent {P}ractice for {D}iagnostics and
                      {T}reatment.},
      journal      = {Cancers},
      volume       = {14},
      number       = {1},
      issn         = {2072-6694},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2022-00091},
      pages        = {126},
      year         = {2021},
      abstract     = {Relapsed 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.},
      subtyp        = {Review Article},
      keywords     = {medulloblastoma (Other) / relapse (Other)},
      cin          = {B062},
      ddc          = {610},
      cid          = {I:(DE-He78)B062-20160331},
      pnm          = {312 - Funktionelle und strukturelle Genomforschung
                      (POF4-312)},
      pid          = {G:(DE-HGF)POF4-312},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:35008290},
      doi          = {10.3390/cancers14010126},
      url          = {https://inrepo02.dkfz.de/record/178465},
}