Clinical outcome of pediatric medulloblastoma patients with Li-Fraumeni syndrome

Anna S. Kolodziejczak, Lea Guerrini-Rousseau, Julien Masliah Planchon, Jonas Ecker, Florian Selt, Martin Mynarek, Denise Obrecht, Martin Sill, Robert J. Autry, Eric Stutheit-Zhao, Steffen Hirsch, Elsa Amouyal, Christelle Dufour, Olivier Ayrault, Jacob Torrejon, Sebastian M. Waszak, Vijay Ramaswamy, Virve Pentikainen, Haci Ahmet Demir, Steven C. CliffordEd C. Schwalbe, Luca Massimi, Matija Snuderl, Kristyn Galbraith, Matthias A. Karajannis, Katherine Hill, Bryan K. Li, Mike Walsh, Christine L. White, Shelagh Redmond, Loizou Loizos, Marcus Jakob, Uwe R. Kordes, Irene Schmid, Julia Hauer, Claudia Blattmann, Maria Filippidou, Gianluca Piccolo, Wolfram Scheurlen, Ahmed Farrag, Kerstin Grund, Christian Sutter, Torsten Pietsch, Stephan Frank, Denis M. Schewe, David Malkin, Myriam Ben-Arush, Astrid Sehested, Tai Tong Wong, Kuo Sheng Wu, Yen Lin Liu, Fernando Carceller, Sabine Mueller, Schuyler Stoller, Michael D. Taylor, Uri Tabori, Eric Bouffet, Marcel Kool, Felix Sahm, Andreas Von Deimling, Andrey Korshunov, Katja Von Hoff, Christian P. Kratz, Dominik Sturm, David T.W. Jones, Stefan Rutkowski, Cornelis M. Van Tilburg, Olaf Witt, Gaëlle Bougeard, Kristian W. Pajtler, Stefan M. Pfister, Franck Bourdeaut, Till Milde

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2 引文 斯高帕斯(Scopus)

摘要

Background: The prognosis for Li-Fraumeni syndrome (LFS) patients with medulloblastoma (MB) is poor. Comprehensive clinical data for this patient group is lacking, challenging the development of novel therapeutic strategies. Here, we present clinical and molecular data on a retrospective cohort of pediatric LFS MB patients. Methods: In this multinational, multicenter retrospective cohort study, LFS patients under 21 years with MB and class 5 or class 4 constitutional TP53 variants were included. TP53 mutation status, methylation subgroup, treatment, progression free- (PFS) and overall survival (OS), recurrence patterns, and incidence of subsequent neoplasms were evaluated. Results: The study evaluated 47 LFS individuals diagnosed with MB, mainly classified as DNA methylation subgroup "SHH_3"(86%). The majority (74%) of constitutional TP53 variants represented missense variants. The 2- and 5-year (y-) PFS were 36% and 20%, and 2- and 5y-OS were 53% and 23%, respectively. Patients who received postoperative radiotherapy (RT) (2y-PFS: 44%, 2y-OS: 60%) or chemotherapy before RT (2y-PFS: 32%, 2y-OS: 48%) had significantly better clinical outcome then patients who were not treated with RT (2y-PFS: 0%, 2y-OS: 25%). Patients treated according to protocols including high-intensity chemotherapy and patients who received only maintenance-type chemotherapy showed similar outcomes (2y-PFS: 42% and 35%, 2y-OS: 68% and 53%, respectively). Conclusions: LFS MB patients have a dismal prognosis. In the presented cohort use of RT significantly increased survival rates, whereas chemotherapy intensity did not influence their clinical outcome. Prospective collection of clinical data and development of novel treatments are required to improve the outcome of LFS MB patients.

原文英語
頁(從 - 到)2273-2286
頁數14
期刊Neuro-Oncology
25
發行號12
DOIs
出版狀態已發佈 - 12月 1 2023

ASJC Scopus subject areas

  • 腫瘤科
  • 神經病學(臨床)
  • 癌症研究

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