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WNT-activated medulloblastoma: lines of therapy

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4 standard-of-care settings across 2 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersHR-positive
Advanced, first line3·
Special situations·1

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersNon-metastatic, standard therapyMaximal safe resection, 23.4 Gy craniospinal radiotherapy with tumour-bed boost (protons where available), then cisplatin, vincristine and cyclophosphamide or lomustine.93
All comersNon-metastatic, de-escalation trials15 Gy (SJMB12) or 18 Gy (ACNS1422) craniospinal radiotherapy with reduced boost and fewer chemotherapy cycles, judged against historical survival.81
All comersMetastatic or residual diseaseHigh-risk therapy: 36 Gy craniospinal radiotherapy with boost and intensified chemotherapy, as for other groups.93

Special situations

SubgroupSettingApproachProducts and trialsEvidence
HR-positiveSurvivorshipNeurocognitive, audiological, endocrine and second-tumour follow-up for life.58

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.