1. Relevance of Molecular Groups in Children with Newly Diagnosed Atypical Teratoid Rhabdoid Tumor: Results from Prospective St. Jude Multi-institutional Trials
- Author
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Sridharan Gururangan, David W. Ellison, Ibrahim Qaddoumi, Sandeep Kumar Dhanda, Santhosh A. Upadhyaya, Robert P. Sanders, Tim Hassall, Marcel Kool, Pascal Johann, Arzu Onar-Thomas, Anne Bendel, Catherine A. Billups, Gang Wu, Anna Vinitsky, Zoltan Patay, Sonia Partap, Daniel J. Indelicato, Gregory T. Armstrong, Ashok Srinivasan, John R. Crawford, Paul G. Fisher, Paul Klimo, Giles W. Robinson, Alberto Broniscer, Eric Bouffet, Frederick A. Boop, Kim E. Nichols, Ruth G. Tatevossian, Roya Mostafavi, Murali Chintagumpala, Brent A. Orr, Amar Gajjar, and Thomas E. Merchant
- Subjects
Male ,0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,DNA Copy Number Variations ,Adjuvant chemotherapy ,Newly diagnosed ,Disease ,Article ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Biomarkers, Tumor ,medicine ,Overall survival ,Humans ,SMARCB1 ,Child ,Germ-Line Mutation ,Rhabdoid Tumor ,business.industry ,Teratoma ,Disease Management ,Infant ,SMARCB1 Protein ,DNA Methylation ,Prognosis ,medicine.disease ,Clinical trial ,Treatment Outcome ,030104 developmental biology ,Methylation profiling ,Child, Preschool ,030220 oncology & carcinogenesis ,Mutation ,Atypical teratoid rhabdoid tumor ,Female ,Disease Susceptibility ,business - Abstract
Purpose: Report relevance of molecular groups to clinicopathologic features, germline SMARCB1/SMARCA4 alterations (GLA), and survival of children with atypical teratoid rhabdoid tumor (ATRT) treated in two multi-institutional clinical trials. Materials and Methods: Seventy-four participants with newly diagnosed ATRT were treated in two trials: infants (SJYC07: age < 3 years; n = 52) and children (SJMB03: age 3–21 years; n = 22), using surgery, conventional chemotherapy (infants), or dose-dense chemotherapy with autologous stem cell rescue (children), and age- and risk-adapted radiotherapy [focal (infants) and craniospinal (CSI; children)]. Molecular groups ATRT-MYC (MYC), ATRT-SHH (SHH), and ATRT-TYR (TYR) were determined from tumor DNA methylation profiles. Results: Twenty-four participants (32%) were alive at time of analysis at a median follow-up of 8.4 years (range, 3.1–14.1 years). Methylation profiling classified 64 ATRTs as TYR (n = 21), SHH (n = 30), and MYC (n = 13), SHH group being associated with metastatic disease. Among infants, TYR group had the best overall survival (OS; P = 0.02). However, outcomes did not differ by molecular groups among infants with nonmetastatic (M0) disease. Children with M0 disease and Conclusions: Among infants, those with ATRT-TYR had the best OS. ATRT-SHH was associated with metastases and consequently with inferior outcomes. Children with nonmetastatic ATRT benefit from postoperative CSI and adjuvant chemotherapy.
- Published
- 2021
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