INNV-26. THE CHALLENGE OF TREATING ADULTS WITH MEDULLOBLASTOMA – THE CANON EXPERIENCE
Bibliographic record
Abstract
Abstract INTRODUCTION Medulloblastoma (MB) is the most common malignant brain tumor in children, but relatively rare in adults. Pediatric treatment paradigms may be applied to young adults despite a paucity of data in this population. Here we aim to describe the characteristics of adults with MB presented at the Canadian Adolescent and Young Adult Neuro-Oncology Network (CANON) multi-disciplinary national rounds along with provider’s current practices in treating these patients. METHODS Cases presented at national rounds between April 2021 – June 2023 including young adults with MB were analyzed to describe patient characteristics and themes of the questions posed. In addition, a survey was sent to all Canadian neuro-oncologists asking about current practice patterns and we describe responses. RESULTS A total of 15 young adults with MB were discussed in this time frame. There were 13 males and 2 females with a median age of 30 years (range 20-61). Subgrouping was available on 12/15, with 7 (46.7%) SHH-activated, 3 (20%) WNT-activated and 3 (20%) Group 4 MB. Ten of the patients presented were new diagnoses with discussion regarding treatment including dose of radiation and chemotherapy protocol. In addition, 4/10 had an incomplete resection and there was discussion regarding a second look surgery. Three patients were presented at time of recurrence, with 2/3 being extra-cranial recurrence. There were a total of 25 responses to the Canadian survey on medulloblastoma, showing variation in practice. Most patients got craniospinal irradiation with 36 Gy. There was wide variation in terms of chemotherapy regimens offered. CONCLUSION There are differences in treatment practices for adults with MB across Canada with many questions regarding what treatment should be offered, specifically related to chemotherapy regimen. This highlights the desperate need to harmonize practice and examine adults as a unique cohort.
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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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.005 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
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".