What would your next line treatment be for a patient previously treated with repeat resection, craniospinal irradiation, and initial cisplatin/vincristine/CCNU with medulloblastoma?
What would be your next treatment for a young adult patient with medulloblastoma refractory to repeat resection, craniospinal irradiation, and initial cisplatin/vincristine/CCNU?
What is your preferred option if the patient doesn't have access to oral chemotherapies due to insurance barriers?
1 Answer
Mednet MemberInvited Expert
Pediatric Hematology/Oncology · C. S. Mott Children’s Hospital, University of Michigan
Answered on
As you will agree, this is an extremely unfortunate situation. I am assuming this patient has progressed either while on therapy or soon after completion? Depending on his age, a potential option is to enroll him on any available clinical trials. PBTC58 study uses intrathecal omburtumab along with chemotherapy in the setting of relapsed medulloblastoma but is currently closed for enrollment. Patients have to be less than 22 years of age at the time of enrollment.
You may also attempt a combination of Avastin, Irinotecan, and TMZ, insurance permitting, according to the COG study that was published recently. Ref: PMID 33844469 by Adam Levy and colleagues.
Hope this helps.
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