# Medulloblastoma molecular groups (WNT, SHH, group 3, group 4)

Source: https://onco.cc/terms/medulloblastoma-molecular-groups/  
OnCo record `medulloblastoma-molecular-groups` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Medulloblastoma is four diseases under one microscope: the WNT group is almost always cured, the SHH group depends on age and TP53, and groups 3 and 4 carry most of the deaths, so the group now steers how much radiation and chemotherapy a child receives.

## Summary

What is measured: the molecular group of the tumour. How: DNA methylation profiling (the Heidelberg classifier) is the reference; where it is unavailable, immunohistochemistry surrogates (nuclear beta-catenin for WNT; GAB1, YAP1 and filamin A for SHH) plus targeted sequencing (CTNNB1, PTCH1, SUFU, SMO, TP53) and FISH or copy-number for MYC and MYCN amplification and isochromosome 17q. WHO 2021 recognises WNT-activated, SHH-activated TP53-wild-type, SHH-activated TP53-mutant, and non-WNT/non-SHH (groups 3 and 4, further split into subgroups I to VIII). Metastatic staging by spinal MRI and cerebrospinal fluid cytology (Chang M0 to M4) and extent of resection sit alongside. What a result changes: WNT (about 10 percent, older children, near 95 percent survival) is the target of trials that cut the craniospinal dose; SHH splits by age and TP53, with infants treated on radiation-sparing chemotherapy, TP53-mutant SHH tumours (often germline Li-Fraumeni) carrying the worst outlook and upstream PTCH1 or SMO mutations making adult SHH tumours candidates for SMO inhibitors; group 3 with MYC amplification is high risk and gets intensified therapy, while group 4 with chromosome 11 loss or whole chromosome 17 gain is low risk and a de-escalation candidate. Where it matters: medulloblastoma and its WNT, SHH and group 3/4 pages; the same methylation approach subgroups ATRT (TYR, SHH, MYC) and ependymoma.

## Fields

- Kind: Term
- Last checked: 2026-09-17
- Also known as: WNT medulloblastoma; WNT-activated medulloblastoma; SHH medulloblastoma; SHH-activated medulloblastoma; group 3 medulloblastoma; group 4 medulloblastoma; non-WNT/non-SHH medulloblastoma; medulloblastoma subgroups; medulloblastoma molecular subgroup; Chang M stage; Chang staging; M0 to M4

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Medulloblastoma
- Wikipedia: https://en.wikipedia.org/wiki/Medulloblastoma

## Connected records

- technologies: [Methylation classifier for brain tumours](https://onco.cc/technologies/cns-tumour-methylation-classifier/)
- terms: [Extent of resection (RANO resect classes)](https://onco.cc/terms/extent-of-resection/), [Immunohistochemistry (IHC)](https://onco.cc/terms/ihc/), [Li-Fraumeni syndrome (germline TP53)](https://onco.cc/terms/li-fraumeni/), [MYCN amplification](https://onco.cc/terms/mycn-amplification/), [TP53-mutated (p53-abnormal)](https://onco.cc/terms/tp53-mutated/)
- drugs: [Sonidegib](https://onco.cc/drugs/sonidegib/), [Vismodegib](https://onco.cc/drugs/vismodegib/)
- cancers: [Group 3 and group 4 medulloblastoma (non-WNT/non-SHH)](https://onco.cc/cancers/medulloblastoma-group-3-4/), [Medulloblastoma](https://onco.cc/cancers/medulloblastoma/), [SHH-activated medulloblastoma](https://onco.cc/cancers/medulloblastoma-shh/), [WNT-activated medulloblastoma](https://onco.cc/cancers/medulloblastoma-wnt/)

---
JSON: https://onco.cc/api/v1/entities/medulloblastoma-molecular-groups.json