MBCL-25. PILOT STUDY OF A SURGERY AND CHEMOTHERAPY-ONLY APPROACH IN THE UPFRONT THERAPY OF CHILDREN WITH WNT-POSITIVE STANDARD RISK MEDULLOBLASTOMA: UPDATED OUTCOMES
Bibliographic record
Abstract
Abstract BACKGROUND Wnt+ medulloblastoma (WPM) is a favorable subtype with EFS > 90% when treating postoperatively with craniospinal irradiation and posterior fossa boost (CSI/XRT) followed by adjuvant chemotherapy. This pilot study explored the safety of omitting radiation in standard-risk WPM. METHODS Subjects had to meet standard-risk criteria (< 1.5 cm2 residual tumor, no metastatic spread, no anaplasia) and have a WPM. Subjects received chemotherapy following the COGACNS0331 AAB-AAB-AAB (A=cisplatin/CCNU/VCR; B=cyclophosphamide/vincristine) backbone. RESULTS Six children were enrolled on study treatment prior to early study closure. Subject #1 completed planned protocol therapy but relapsed 3 months following the completion of therapy. Subject #2 completed planned protocol therapy but relapsed 6 months following the completion of therapy. In both cases, relapse was local and disseminated. Further accrual was halted. Both subjects were salvaged with CSI/XRT followed by adjuvant chemotherapy. Of the remaining 4 subjects, two had recently completed planned protocol therapy at the time of study closure and received CSI/XRT while in remission and remain in remission approximately one year from the completion of treatment. One subject aborted protocol therapy and transitioned to a Head Start regimen and remains in remission 10 months from completion of therapy. The final subject had just completed protocol therapy and had new areas of restricted diffusion concerning for early relapse. Went on to receive CSI/XRT but subsequently relapsed and is now receiving salvage chemotherapy. CONCLUSIONS Chemotherapy following ACNS0331, omitting CSI/XRT, appears to be insufficient for the treatment of non-metastatic WPM.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".