{"entity":{"id":"paper-acns0332-leary-jama-oncol-2021","kind":"paper","name":"ACNS0332: carboplatin during radiotherapy and isotretinoin maintenance in high-risk medulloblastoma","aka":[],"tldr":"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).\n\nCarboplatin 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.","asOf":"2026-09-17","links":[{"label":"JAMA Oncol 2021","url":"https://doi.org/10.1001/jamaoncol.2021.2224"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/34292305/"}],"tags":[],"related":[],"cancers":["medulloblastoma-group-3-4"],"sections":[],"technologies":[],"targets":[],"drugs":["carboplatin"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["acns0332"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["jama-oncology"],"dependsOn":[],"notes":[],"journal":"JAMA Oncology","year":2021,"doi":"10.1001/jamaoncol.2021.2224","pmid":"34292305","authors":"Leary SES, Packer RJ, Li Y, et al.","paperType":"rct","findings":["Group 3: five-year event-free survival 73.2 percent with carboplatin vs 53.7 percent without.","No benefit from isotretinoin maintenance."],"whatItMeans":"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."],"changedPractice":true,"participants":261},"route":"/key-papers/paper-acns0332-leary-jama-oncol-2021/","neighbours":{"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/"}],"drug":[{"id":"carboplatin","kind":"drug","name":"Carboplatin","route":"/drugs/carboplatin/"}],"trial":[{"id":"acns0332","kind":"trial","name":"COG ACNS0332","route":"/trials/acns0332/"}],"journal":[{"id":"jama-oncology","kind":"journal","name":"JAMA Oncology","route":"/journals/jama-oncology/"}]}}