ACNS0332: carboplatin during radiotherapy and isotretinoin maintenance in high-risk medulloblastoma
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.
Overview
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.
- Group 3: five-year event-free survival 73.2 percent with carboplatin vs 53.7 percent without.
- No benefit from isotretinoin maintenance.
Carboplatin radiosensitisation is used for high-risk group 3 medulloblastoma, an example of subgroup-directed therapy.
- Subgroup analysis; overall effect of carboplatin was not significant.