# ACNS0332: carboplatin during radiotherapy and isotretinoin maintenance in high-risk medulloblastoma

Source: https://onco.cc/key-papers/paper-acns0332-leary-jama-oncol-2021/  
OnCo record `paper-acns0332-leary-jama-oncol-2021` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adding daily carboplatin during craniospinal radiotherapy improved event-free survival in children with high-risk group 3 medulloblastoma, but not in other subgroups, while isotretinoin maintenance did not help.

## Summary

Children's Oncology Group phase 3 trial of 261 children with high-risk medulloblastoma randomised to 36 Gy craniospinal radiotherapy with or without daily carboplatin, and to maintenance isotretinoin or not (the isotretinoin randomisation was stopped early for futility).

Carboplatin improved five-year event-free survival in group 3 tumours (73.2 versus 53.7 percent) but not overall or in group 4, and molecular subgroup was strongly prognostic.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: JAMA Oncology
- Year: 2021
- DOI: 10.1001/jamaoncol.2021.2224
- Authors: Leary SES, Packer RJ, Li Y, et al.
- Findings: Group 3: five-year event-free survival 73.2 percent with carboplatin vs 53.7 percent without.; No benefit from isotretinoin maintenance.
- What it means: Carboplatin radiosensitisation is used for high-risk group 3 medulloblastoma, an example of subgroup-directed therapy.
- Caveats: Subgroup analysis; overall effect of carboplatin was not significant.

## Sources

- JAMA Oncol 2021: https://doi.org/10.1001/jamaoncol.2021.2224
- PubMed: https://pubmed.ncbi.nlm.nih.gov/34292305/

## Connected records

- cancers: [Group 3 and group 4 medulloblastoma (non-WNT/non-SHH)](https://onco.cc/cancers/medulloblastoma-group-3-4/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/)
- trials: [COG ACNS0332](https://onco.cc/trials/acns0332/)
- journals: [JAMA Oncology](https://onco.cc/journals/jama-oncology/)

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