GE-27 * THERAPEUTIC IMPLICATIONS OF MEDULLOBLASTOMA SUBGROUPS IN CHILDREN OVER AGE 3: A SINGLE CENTRE POPULATION BASED EXPERIENCE
Bibliographic record
Abstract
OBJECTIVES: The advent of integrated genomics has fundamentally changed our understanding of medulloblastoma. Although survival differences have been shown to exist between the four principle subgroups, treatment related differences have yet to be elucidated. We sought to delineate these differences at a large referral centre. METHODS: All patients over age 3 treated with surgery, craniospinal irradiation and adjuvant chemotherapy were identified at the Hospital for Sick Children in Toronto from 1998-2012. RESULTS: Ninety-four patients were identified who met our inclusion criteria. Two periods were identified, those patients treated prior to 2006 as per the open protocols of the Children's Oncology Group (CCG9961, POG9631), and patients treated after 2006 treated as per the SJMB03 protocol. Five-year progression free survival over the entire cohort was 78%. When stratified by treatment, 5 year survival pre and post 2006 were identical (76.8% pre-2006 and 79.3% post-2006). When re-analysed in a subgroup specific manner, we find no significant differences in progression-free survival pre and post 2006. Strikingly, we found that Group 3 and 4 patients have excellent survivals compared to those previously reported, with 5 year progression-free survival in average risk Group 4 patients of over 90% and over 75% in average risk Group 3 patients regardless of treatment protocol. SHH patients did relatively poorly across both treatment protocols with 5 year progression free survival of 60% likely owing to a high proportion of TP53 mutated patients. CONCLUSIONS: In a cohort of homogenously treated patients over age 3, progression free survival appears to be improved compared to initial reports based on retrospective cohorts. The impact of subgroup affiliation in children over age 3 needs to assessed in large prospectively treated cooperative protocols to determine the subgroup specificity of treatment regiments.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".