{"entity":{"id":"medulloblastoma-molecular-groups","kind":"term","name":"Medulloblastoma molecular groups (WNT, SHH, group 3, group 4)","aka":["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"],"tldr":"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.","asOf":"2026-09-17","wikipedia":"https://en.wikipedia.org/wiki/Medulloblastoma","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Medulloblastoma"}],"tags":[],"related":["cns-tumour-methylation-classifier","tp53-mutated","mycn-amplification","li-fraumeni","vismodegib","sonidegib","extent-of-resection","ihc"],"cancers":["medulloblastoma","medulloblastoma-wnt","medulloblastoma-shh","medulloblastoma-group-3-4"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Biomarkers"},"route":"/terms/medulloblastoma-molecular-groups/","neighbours":{"technology":[{"id":"cns-tumour-methylation-classifier","kind":"technology","name":"Methylation classifier for brain tumours","route":"/technologies/cns-tumour-methylation-classifier/"}],"term":[{"id":"extent-of-resection","kind":"term","name":"Extent of resection (RANO resect classes)","route":"/terms/extent-of-resection/"},{"id":"ihc","kind":"term","name":"Immunohistochemistry (IHC)","route":"/terms/ihc/"},{"id":"li-fraumeni","kind":"term","name":"Li-Fraumeni syndrome (germline TP53)","route":"/terms/li-fraumeni/"},{"id":"mycn-amplification","kind":"term","name":"MYCN amplification","route":"/terms/mycn-amplification/"},{"id":"tp53-mutated","kind":"term","name":"TP53-mutated (p53-abnormal)","route":"/terms/tp53-mutated/"}],"drug":[{"id":"sonidegib","kind":"drug","name":"Sonidegib","route":"/drugs/sonidegib/"},{"id":"vismodegib","kind":"drug","name":"Vismodegib","route":"/drugs/vismodegib/"}],"cancer":[{"id":"medulloblastoma-group-3-4","kind":"cancer","name":"Group 3 and group 4 medulloblastoma (non-WNT/non-SHH)","route":"/cancers/medulloblastoma-group-3-4/"},{"id":"medulloblastoma","kind":"cancer","name":"Medulloblastoma","route":"/cancers/medulloblastoma/"},{"id":"medulloblastoma-shh","kind":"cancer","name":"SHH-activated medulloblastoma","route":"/cancers/medulloblastoma-shh/"},{"id":"medulloblastoma-wnt","kind":"cancer","name":"WNT-activated medulloblastoma","route":"/cancers/medulloblastoma-wnt/"}]}}