Group 3 and group 4 medulloblastoma (non-WNT/non-SHH): lines of therapy
5 standard-of-care settings across 4 lines and 4 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
| Line | All comers | Age group | HR-positive | Risk group |
|---|---|---|---|---|
| Advanced, first line | · | · | · | 1 |
| Second line | 1 | · | · | · |
| Special situations | · | · | 1 | · |
| Other settings | 1 | 1 | · | · |
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| Risk group | High risk (metastatic, residual disease or MYC amplification) | 36 Gy craniospinal radiotherapy with boost, daily carboplatin during radiotherapy for group 3 (ACNS0332), then cisplatin, vincristine and cyclophosphamide. | NCI PDQ: Childhood Medulloblastoma and Other CNS Embryonal Tumors Treatment (health professional version) | 93 |
Second line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Relapsed | Temozolomide with irinotecan, bevacizumab, re-irradiation or high-dose chemotherapy; almost never curative; early-phase trials. | NCI PDQ: Childhood Medulloblastoma and Other CNS Embryonal Tumors Treatment (health professional version) | 98 |
Special situations
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| HR-positive | Survivorship | Neurocognitive, endocrine, hearing, vascular and second-tumour follow-up for life. | NCI PDQ: Childhood Medulloblastoma and Other CNS Embryonal Tumors Treatment (health professional version) | 58 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Average risk (aged 3 or over, no metastases, residual under 1.5 square centimetres) | Maximal safe resection, 23.4 Gy craniospinal radiotherapy with tumour-bed boost (ACNS0331 showed 18 Gy is inferior), then cisplatin, vincristine and cyclophosphamide or lomustine. | NCI PDQ: Childhood Medulloblastoma and Other CNS Embryonal Tumors Treatment (health professional version) | 93 | |
| Age group | Infants under three | Intensive chemotherapy with methotrexate, then high-dose consolidation with stem cell rescue, to avoid or delay craniospinal radiotherapy. | NCI PDQ: Childhood Medulloblastoma and Other CNS Embryonal Tumors Treatment (health professional version) | 87 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.