TY - JOUR A1 - Nemes, Karolina A1 - Johann, Pascal D. A1 - Steinbügl, Mona A1 - Gruhle, Miriam A1 - Bens, Susanne A1 - Kachanov, Denis A1 - Teleshova, Margarita A1 - Hauser, Peter A1 - Simon, Thorsten A1 - Tippelt, Stephan A1 - Eberl, Wolfgang A1 - Chada, Martin A1 - Lopez, Vicente Santa-Maria A1 - Grigull, Lorenz A1 - Hernáiz-Driever, Pablo A1 - Eyrich, Matthias A1 - Pears, Jane A1 - Milde, Till A1 - Reinhard, Harald A1 - Leipold, Alfred A1 - van de Wetering, Marianne A1 - Gil-da-Costa, Maria João A1 - Ebetsberger-Dachs, Georg A1 - Kerl, Kornelius A1 - Lemmer, Andreas A1 - Boztug, Heidrun A1 - Furtwängler, Rhoikos A1 - Kordes, Uwe A1 - Vokuhl, Christian A1 - Hasselblatt, Martin A1 - Bison, Brigitte A1 - Kröncke, Thomas A1 - Melchior, Patrick A1 - Timmermann, Beate A1 - Gerss, Joachim A1 - Siebert, Reiner A1 - Frühwald, Michael C. T1 - 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 JF - Cancers N2 - 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. KW - atypical teratoid rhabdoid tumors KW - extracranial malignant rhabdoid tumor KW - RTPS1 KW - RTPS2 KW - germline mutation KW - EU-RHAB registry Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-270730 SN - 2072-6694 VL - 14 IS - 9 ER - TY - JOUR A1 - Bartelheim, Kerstin A1 - Nemes, Karolina A1 - Seeringer, Angela A1 - Kerl, Kornelius A1 - Buechner, Jochen A1 - Boos, Joachim A1 - Graf, Norbert A1 - Dürken, Matthias A1 - Gerss, Joachim A1 - Hasselblatt, Martin A1 - Kortmann, Rolf-Dieter A1 - Teichert von Luettichau, Irene A1 - Nagel, Inga A1 - Nygaard, Randi A1 - Oyen, Florian A1 - Quiroga, Eduardo A1 - Schlegel, Paul-Gerhardt A1 - Schmid, Irene A1 - Schneppenheim, Reinhard A1 - Siebert, Reiner A1 - Solano-Paez, Palma A1 - Timmermann, Beate A1 - Warmuth-Metz, Monika A1 - Frühwald, Michael Christoph T1 - Improved 6-year overall survival in AT/RT - results of the registry study Rhabdoid 2007 JF - Cancer Medicine N2 - Atypical teratoid rhabdoid tumors (AT/RT) are characterized by mutations and subsequent inactivation of SMARCB1 (INI1, hSNF5), a predilection for very young children and an unfavorable outcome. The European Registry for rhabdoid tumors (EU‐RHAB) was established to generate a common European database and to establish a standardized treatment regimen as the basis for phase I/II trials. Thus, genetic analyses, neuropathologic and radiologic diagnoses, and a consensus treatment regimen were prospectively evaluated. From 2005 to 2009, 31 patients with AT/RT from four countries were recruited into the registry study Rhabdoid 2007 and treated with systemic and intraventricular chemotherapy. Eight patients received high‐dose chemotherapy, 23 radiotherapy, and 17 maintenance therapy. Reference evaluations were performed in 64% (genetic analyses, FISH, MLPA, sequencing) up to 97% (neuropathology, INI1 stain). Germ‐line mutations (GLM) were detected in 6/21 patients. Prolonged overall survival was associated with age above 3 years, radiotherapy and achievement of a complete remission. 6‐year overall and event‐free survival rates were 46% (±0.10) and 45% (±0.09), respectively. Serious adverse events and one treatment‐related death due to insufficiency of a ventriculo peritoneal shunt (VP‐shunt) and consecutive herniation were noted. Acquisition of standardized data including reference diagnosis and a standard treatment schedule improved data quality along with a survival benefit. Treatment was feasible with significant but manageable toxicity. Although our analysis is biased due to heterogeneous adherence to therapy, EU‐RHAB provides the best available basis for phase I/II clinical trials. KW - AT/RT KW - EU‐RHAB Registry KW - pediatric brain tumor KW - Rhabdoid 2007 Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-164799 VL - 5 IS - 8 ER -