# Intertumoural heterogeneity within medulloblastoma subgroups

Source: https://onco.cc/key-papers/paper-cavalli-medulloblastoma-subtypes-cancer-cell-2017/  
OnCo record `paper-cavalli-medulloblastoma-subtypes-cancer-cell-2017` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Combining gene expression and methylation data from 763 medulloblastomas split the four subgroups into twelve subtypes with distinct genetics and survival, refining who is at high and low risk within each group.

## Summary

Integrative clustering of 763 primary medulloblastomas using DNA methylation and gene expression identifying twelve subtypes: two WNT, four SHH, three group 3 and three group 4, each with distinct copy-number alterations, mutations, age distribution and survival.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Cancer Cell
- Year: 2017
- DOI: 10.1016/j.ccell.2017.05.005
- Authors: Cavalli FMG, Remke M, Rampasek L, et al.
- Findings: Twelve subtypes with distinct survival; for example SHH-alpha (TP53-mutant, children) had poor outcome and group 3-gamma (MYC-amplified) the worst.
- What it means: Subtype-level classification, particularly separating infant and TP53-mutant SHH tumours and MYC-amplified group 3 tumours, guides current risk stratification and trial design.
- Caveats: Subtype assignment requires methylation profiling.

## Sources

- Cancer Cell 2017: https://doi.org/10.1016/j.ccell.2017.05.005
- PubMed: https://pubmed.ncbi.nlm.nih.gov/28609654/

## Connected records

- cancers: [Group 3 and group 4 medulloblastoma (non-WNT/non-SHH)](https://onco.cc/cancers/medulloblastoma-group-3-4/), [SHH-activated medulloblastoma](https://onco.cc/cancers/medulloblastoma-shh/), [WNT-activated medulloblastoma](https://onco.cc/cancers/medulloblastoma-wnt/)
- journals: [Cancer Cell](https://onco.cc/journals/cancer-cell/)

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