Spinal cord tumours (intramedullary and intradural): lines of therapy
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.
Second line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Incompletely resected, high grade or recurrent | Focal radiotherapy with intensity-modulated or proton techniques; temozolomide for high-grade astrocytoma by extrapolation. | NCCN Guidelines: Central Nervous System Cancers | 93 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Intramedullary ependymoma or haemangioblastoma | Gross total resection with intraoperative neurophysiological monitoring; complete removal is usually curative and needs no adjuvant treatment. | NCCN Guidelines: Central Nervous System Cancers | 40 | |
| All comers | Von Hippel-Lindau haemangioblastoma not needing immediate surgery | Belzutifan, the HIF-2 alpha inhibitor approved for VHL-associated central nervous system haemangioblastomas, with surveillance imaging. | FDA label 2021 | 92 | |
| KMT2A | Intradural extramedullary meningioma or schwannoma | Resection when symptomatic or growing; radiosurgery for residual or recurrent tumour where the cord dose allows; observation for small asymptomatic lesions. | NCCN Guidelines: Central Nervous System Cancers | 63 |
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.