@article{GaabAdolphTippeltetal.2022, author = {Gaab, Christine and Adolph, Jonas E. and Tippelt, Stephan and Mikasch, Ruth and Obrecht, Denise and Mynarek, Martin and Rutkowski, Stefan and Pfister, Stefan M. and Milde, Till and Witt, Olaf and Bison, Brigitte and Warmuth-Metz, Monika and Kortmann, Rolf-Dieter and Dietzsch, Stefan and Pietsch, Torsten and Timmermann, Beate and Str{\"a}ter, Ronald and Bode, Udo and Faldum, Andreas and Kwiecien, Robert and Fleischhack, Gudrun}, title = {Local and systemic therapy of recurrent medulloblastomas in children and adolescents: results of the P-HIT-REZ 2005 Study}, series = {Cancers}, volume = {14}, journal = {Cancers}, number = {3}, issn = {2072-6694}, doi = {10.3390/cancers14030471}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-254809}, year = {2022}, abstract = {Recurrent medulloblastomas are associated with survival rates <10\%. Adequate multimodal therapy is being discussed as having a major impact on survival. In this study, 93 patients with recurrent medulloblastoma treated in the German P-HIT-REZ 2005 Study were analyzed for survival (PFS, OS) dependent on patient, disease, and treatment characteristics. The median age at the first recurrence was 10.1 years (IQR: 6.9-16.1). Median PFS and OS, at first recurrence, were 7.9 months (CI: 5.7-10.0) and 18.5 months (CI: 13.6-23.5), respectively. Early relapses/progressions (<18 months, n = 30/93) found mainly in molecular subgroup 3 were associated with markedly worse median PFS (HR: 2.34) and OS (HR: 3.26) in regression analyses. A significant survival advantage was found for the use of volume-reducing surgery as well as radiotherapy. Intravenous chemotherapy with carboplatin and etoposide (ivCHT, n = 28/93) showed improved PFS and OS data and the best objective response rate (ORR) was 66.7\% compared to oral temozolomide (oCHT, n = 47/93) which was 34.8\%. Intraventricular (n = 43) as well as high-dose chemotherapy (n = 17) at first relapse was not related to a significant survival benefit. Although the results are limited due to a non-randomized study design, they may serve as a basis for future treatment decisions in order to improve the patients' survival.}, language = {en} } @article{NemesJohannSteinbuegletal.2022, author = {Nemes, Karolina and Johann, Pascal D. and Steinb{\"u}gl, Mona and Gruhle, Miriam and Bens, Susanne and Kachanov, Denis and Teleshova, Margarita and Hauser, Peter and Simon, Thorsten and Tippelt, Stephan and Eberl, Wolfgang and Chada, Martin and Lopez, Vicente Santa-Maria and Grigull, Lorenz and Hern{\´a}iz-Driever, Pablo and Eyrich, Matthias and Pears, Jane and Milde, Till and Reinhard, Harald and Leipold, Alfred and van de Wetering, Marianne and Gil-da-Costa, Maria Jo{\~a}o and Ebetsberger-Dachs, Georg and Kerl, Kornelius and Lemmer, Andreas and Boztug, Heidrun and Furtw{\"a}ngler, Rhoikos and Kordes, Uwe and Vokuhl, Christian and Hasselblatt, Martin and Bison, Brigitte and Kr{\"o}ncke, Thomas and Melchior, Patrick and Timmermann, Beate and Gerss, Joachim and Siebert, Reiner and Fr{\"u}hwald, Michael C.}, title = {Infants and newborns with atypical teratoid rhabdoid tumors (ATRT) and extracranial malignant rhabdoid tumors (eMRT) in the EU-RHAB registry: a unique and challenging population}, series = {Cancers}, volume = {14}, journal = {Cancers}, number = {9}, issn = {2072-6694}, doi = {10.3390/cancers14092185}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-270730}, year = {2022}, abstract = {Introduction: Malignant rhabdoid tumors (MRT) predominantly affect infants and young children. Patients below six months of age represent a particularly therapeutically challenging group. Toxicity to developing organ sites limits intensity of treatment. Information on prognostic factors, genetics, toxicity of treatment and long-term outcomes is sparse. Methods: Clinical, genetic, and treatment data of 100 patients (aged below 6 months at diagnosis) from 13 European countries were analyzed (2005-2020). Tumors and matching blood samples were examined for SMARCB1 mutations using FISH, MLPA and Sanger sequencing. DNA methylation subgroups (ATRT-TYR, ATRT-SHH, and ATRT-MYC) were determined using 450 k / 850 k-profiling. Results: A total of 45 patients presented with ATRT, 29 with extracranial, extrarenal (eMRT) and 9 with renal rhabdoid tumors (RTK). Seventeen patients demonstrated synchronous tumors (SYN). Metastases (M+) were present in 27\% (26/97) at diagnosis. A germline mutation (GLM) was detected in 55\% (47/86). DNA methylation subgrouping was available in 50\% (31 / 62) with ATRT or SYN; for eMRT, methylation-based subgrouping was not performed. The 5-year overall (OS) and event free survival (EFS) rates were 23.5 ± 4.6\% and 19 ± 4.1\%, respectively. Male sex (11 ± 5\% vs. 35.8 ± 7.4\%), M+ stage (6.1 ± 5.4\% vs. 36.2 ± 7.4\%), presence of SYN (7.1 ± 6.9\% vs. 26.6 ± 5.3\%) and GLM (7.7 ± 4.2\% vs. 45.7 ± 8.6\%) were significant prognostic factors for 5-year OS. Molecular subgrouping and survival analyses confirm a previously described survival advantage for ATRT-TYR. In an adjusted multivariate model, clinical factors that favorably influence the prognosis were female sex, localized stage, absence of a GLM and maintenance therapy. Conclusions: In this cohort of homogenously treated infants with MRT, significant predictors of outcome were sex, M-stage, GLM and maintenance therapy. We confirm the need to stratify which patient groups benefit from multimodal treatment, and which need novel therapeutic strategies. Biomarker-driven tailored trials may be a key option.}, language = {en} }