Medulloblastoma in the Molecular Era.
Medulloblastoma in the Molecular Era.
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DOI：
10.3340/jkns.2018.0028
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发表时间：
2018-05
影响因子：
1.6
通讯作者：
Taylor MD
中科院分区：
文献类型：
--
作者：
Miranda Kuzan-Fischer C;Juraschka K;Taylor MD
髓母细胞瘤是儿童最常见的恶性脑肿瘤，并且仍然是儿童癌症相关死亡的主要原因。重大的科学进步已经改变了对髓母细胞瘤的理解，导致四种不同的临床和分子亚组的识别，即无翼（WNT），音刺猬，第3组和第4组。亚组分类结合亚组特异性分子改变的识别也导致髓母细胞瘤患者风险分层的重大变化，这些变化已经开始改变临床试验设计，其中新识别的亚组被纳入个体化治疗组。尽管最近取得了这些进展，但由于几个原因，鉴定有效的靶向治疗仍然是一个挑战。首先，在四个亚组中存在显著的分子异质性，这意味着单独的分类系统可能不足以预测对特定治疗的反应。其次，大多数新药物目前都是在复发时进行测试，之后通过放疗和化疗施加了显着的选择性压力。最近的研究表明，在转移性和复发性肿瘤群体中存在对表现出与原发性肿瘤遗传差异的肿瘤亚克隆的选择。因此，在复发时进行肿瘤复发可能是准确选择患者进行个性化治疗所必需的。
Medulloblastoma is the most common malignant brain tumor of childhood and remains a major cause of cancer related mortality in children. Significant scientific advancements have transformed the understanding of medulloblastoma, leading to the recognition of four distinct clinical and molecular subgroups, namely wingless (WNT), sonic hedgehog, group 3, and group 4. Subgroup classification combined with the recognition of subgroup specific molecular alterations has also led to major changes in risk stratification of medulloblastoma patients and these changes have begun to alter clinical trial design, in which the newly recognized subgroups are being incorporated as individualized treatment arms. Despite these recent advancements, identification of effective targeted therapies remains a challenge for several reasons. First, significant molecular heterogeneity exists within the four subgroups, meaning this classification system alone may not be sufficient to predict response to a particular therapy. Second, the majority of novel agents are currently tested at the time of recurrence, after which significant selective pressures have been exerted by radiation and chemotherapy. Recent studies demonstrate selection of tumor sub-clones that exhibit genetic divergence from the primary tumor, exist within metastatic and recurrent tumor populations. Therefore, tumor resampling at the time of recurrence may become necessary to accurately select patients for personalized therapy.
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影响因子：
8.8
作者：
Badodi S;Dubuc A;Zhang X;Rosser G;Da Cunha Jaeger M;Kameda-Smith MM;Morrissy AS;Guilhamon P;Suetterlin P;Li XN;Guglielmi L;Merve A;Farooq H;Lupien M;Singh SK;Basson MA;Taylor MD;Marino S
通讯作者：
Marino S
影响因子：
11.2
作者：
Faria, Claudia C.;Golbourn, Brian J.;Rutka, James T.
通讯作者：
Rutka, James T.
影响因子：
45.3
作者：
Geyer, JR;Sposto, R;Shiminski-Maher, T
通讯作者：
Shiminski-Maher, T
影响因子：
4.8
作者：
Kuzan-Fischer, ClaudiaM;Stucklin, Ana S. Guerreiro;Taylor, Michael D.
通讯作者：
Taylor, Michael D.
DOI：
10.1158/1078-0432.ccr-13-2281
发表时间：
2014-02-15
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
Bandopadhayay P;Bergthold G;Nguyen B;Schubert S;Gholamin S;Tang Y;Bolin S;Schumacher SE;Zeid R;Masoud S;Yu F;Vue N;Gibson WJ;Paolella BR;Mitra SS;Cheshier SH;Qi J;Liu KW;Wechsler-Reya R;Weiss WA;Swartling FJ;Kieran MW;Bradner JE;Beroukhim R;Cho YJ
通讯作者：
Cho YJ