Personalized treatment options of refractory and relapsed medulloblastoma in children: literature review

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Abstract

Medulloblastoma (MB) is the most common malignant tumor of the central nervous system in pediatric patients. Despite the complex anticancer therapy approach, refractory and relapsing forms of the disease remain fatal in most cases and account for approximately 30%. To date, repeated surgery, radiation, and chemotherapy can be used as life-prolonging treatment options; nevertheless, it should be emphasized that there are no standardized approaches based on existing data of molecular variants of MB. It is obvious that only a deep understanding of the biological mechanisms in association with clinical aspects in refractory and relapsing forms of MB would make it possible to personalize second- and subsequent-line therapy in order to achieve maximum efficiency and minimize early and long-term toxicity. The article presents the current understanding of prognostic factors in relapsed/refractory forms of MB, methods of modern diagnostics, as well as existing and perspective treatment options based on the biological and clinical aspects of the disease.

About the authors

Yulia V. Dinikina

Almazov National Medical Research Centre

Author for correspondence.
Email: dinikinayulia@mail.ru
ORCID iD: 0000-0002-2003-0982

Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Olga G. Zheludkova

Voino-Yasenetskiy Scientific and Practical Center of Specialized Healthcare for Children

Email: clelud@mail.ru
ORCID iD: 0000-0002-8607-3635

D. Sci. (Med.), Prof.

Russian Federation, Moscow

Margarita B. Belogurova

Almazov National Medical Research Centre

Email: deton.hospital31@inbox.ru
ORCID iD: 0000-0002-7471-7181

D. Sci. (Med.), Prof.

Russian Federation, Saint Petersburg

Dmitry M. Spelnikov

Darwin Tech Labs

Email: d.spelnikov@gmail.com
ORCID iD: 0000-0002-3475-1780

Senior Research Officer

Kazakhstan, Astana

Nikolai N. Osipov

Saint Petersburg Department of Steklov Mathematical Institute; Saint Petersburg State University

Email: nicknick@pdmi.ras.ru
ORCID iD: 0000-0002-5391-3917

Cand. Sci. (Phys.-Math.)

Russian Federation, Saint Petersburg; Saint Petersburg

Irina L. Nikitina

Almazov National Medical Research Centre

Email: nikitina0901@gmail.com
ORCID iD: 0000-0003-4013-0785

D. Sci. (Med.), Prof.

Russian Federation, Saint Petersburg

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