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Green K, Panagopoulou P, D'Arco F, O'Hare P, Bowman R, Walters B, Dahl C, Jorgensen M, Patel P, Slater O, Ahmed R, Bailey S, Carceller F, Collins R, Corley E, English M, Howells L, Kamal A, Kilday JP, Lowis S, Lumb B, Pace E, Picton S, Pizer B, Shafiq A, Uzunova L, Wayman H, Wilson S, Hargrave D, Opocher E. A Nationwide Evaluation of Bevacizumab-based Treatments in Paediatric Low-Grade Glioma in the UK: Safety. Efficacy, Visual Morbidity and Outcomes. Neuro Oncol 2022; 25:774-785. [PMID: 36239316 PMCID: PMC10076941 DOI: 10.1093/neuonc/noac223] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Bevacizumab is increasingly used in children with Paediatric Low-Grade Glioma (PLGG) despite limited evidence. A nationwide UK service evaluation was conducted to provide larger cohort 'real life' safety and efficacy data including functional visual outcomes. METHODS Children receiving Bevacizumab-based treatments (BBT) for PLGG (2009-2020) from 11 centres were included. Standardised neuro-radiological (RANO-LGG) and visual (logMAR visual acuity) criteria were used to assess clinical-radiological correlation, survival outcomes and multivariate prognostic analysis. RESULTS Eighty-eight children with PLGG received BBT either as 3 rd line with Irinotecan (85%) or alongside 1 st/2 nd line chemotherapies (15%). Toxicity was limited and minimal. Partial response (PR, 40%), stable disease (SD, 49%), and progressive disease (PD, 11%) were seen during BBT. However, 65% progressed at 8 months (median) from BBT cessation, leading to a radiology-based 3yr-progression-free survival (PFS) of 29%. Diencephalic syndrome (p= 0.03) was associated with adverse PFS. Pre-existing visual morbidity included unilateral (25%) or bilateral (11%) blindness. Improvement (29%) or stabilisation (49%) of visual acuity were achieved, more often in patients' best eyes. Vision deteriorated during BBT in 14 (22%), with 3-year visual-PFS of 53%; more often in patients' worst eyes. A superior visual outcome (p=0.023) was seen in Neurofibromatosis type 1-associated Optic Pathway Glioma (OPG). Concordance between visual and radiological responses was 36%; optimised to 48% using only best eye responses. CONCLUSIONS BBTs provide effective short-term PLGG control and delay further progression, with a better sustained visual (best >worst eye) than radiological response. Further research could optimise the role of BBTs towards a potentially sight-saving strategy in OPG.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Olga Slater
- Great Ormond Street Hospital London, United Kingdom
| | | | - Simon Bailey
- Great North Children's Hospital Newcastle, United Kingdom
| | | | | | | | | | | | - Ahmed Kamal
- Birmingham Children's Hospital, United Kingdom
| | - John-Paul Kilday
- Royal Manchester Children's Hospital, United Kingdom.,The Centre for Paediatric, Teenage and Young Adult Cancer Sciences, The University of Manchester, United Kingdom
| | | | - Blanche Lumb
- Noah's Ark Children's Hospital for Wales, United Kingdom
| | - Erika Pace
- The Royal Marsden Hospital London, United Kingdom
| | | | - Barry Pizer
- Alder Hey Children's Hospital Liverpool, United Kingdom
| | - Ayad Shafiq
- Great North Children's Hospital Newcastle, United Kingdom
| | - Lena Uzunova
- Noah's Ark Children's Hospital for Wales, United Kingdom
| | | | | | | | - Enrico Opocher
- Great Ormond Street Hospital London, United Kingdom.,Padua University Hospital, Padua, Italy
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2
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Green K, Panagopoulou P, D’Arco F, O'Hare P, Bowman R, Walters B, Dahl C, Jorgensen M, Patel P, Slater O, Ahmed R, Bailey S, Carceller F, Collins R, Corley E, English M, Hayden J, Howells L, Kamal A, Kilday JP, Lowis S, Lumb B, Micic T, Mitra D, Pace E, Picton S, Pizer B, Shafiq A, Uzunova L, Wilson S, Wayman H, Hargrave D, Opocher E. LGG-09. A Nationwide Service Evaluation of Safety, Radiologic and Visual Outcome Refining Bevacizumab-based Treatments in Children with Progressive Low-Grade Glioma. Neuro Oncol 2022. [PMCID: PMC9164923 DOI: 10.1093/neuonc/noac079.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
INTRODUCTION: Bevacizumab/Irinotecan is currently 3rd-line treatment in the UK for progressive Paediatric Low-Grade Glioma (PLGG) based on limited evidence. A nationwide service evaluation was conducted to review its safety and efficacy amongst a larger cohort.
METHODS: Data from children with PLGG receiving Bevacizumab-based Treatments (BBT) from 11 UK Centres (2009-2020) were reviewed. Radiological and visual outcomes were based on standardized measurements. Clinical-radiological correlation was investigated. Time to progression from BBT stop, progression free-survival (PFS) curves and multivariate analysis of prognostic factors (p 0.05) were performed.
RESULTS: 88 children with PLGG (88% OPG, 24% NF1) had BBT for radiological (43%), visual (20%) or combined (27%) progression, after 40 months (median) from diagnosis. Amongst OPG cases, visual acuity (VA) per eye (better/worse) before BBT was logMAR 0.0-0.3 (23/7) 0.3 - 1.0 (27/20), > 1.0 (14/18) and LP/NLP (8/27), with 19/8 children respectively blind (LP/NLP) in one or both eyes. Bevacizumab 10 mg/kg every 14 days (median 24 doses) was given as 3rd line+ with Irinotecan (85%) or alongside 1st/2nd line chemo (15%) leading to remarkable radiological (88%) and visual (74%) responses (stable or improved) within 3-6 months, with limited toxicity. 12% progressed on treatment, and 8% died unrelated to BBT. After initial response 65% progressed at a median of 8 months (4 - 23) after BBT, resulting in 3-year-all-causes-PFS of 16% and 3-yr-visual-PFS of 45% from start of BBT. Visual concordance with MRI was poor (36%) but increases (47%) when better-eye determines visual outcome. Lack of NF1 and diencephalic syndrome (DS) at presentation were independent negative prognostic factors for PFS.
CONCLUSIONS: A remarkable but transient effect of BBT has been confirmed. Visual > radiological responses can be sustained after BBT. Variations in current BBT strategies justifies further research, including the potential upfront use alongside conventional first-line chemotherapy as sight-saving strategy.
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Affiliation(s)
| | - Paraskevi Panagopoulou
- Great Ormond Street Hospital , London , United Kingdom
- Aristotle University of Thessaloniki Medical School , Thessaloniki , Greece
| | | | - Patricia O'Hare
- Children's Hospital Belfast , Belfast , United Kingdom
- Great Ormond Street Hospital , London , United Kingdom
| | | | | | | | | | - Pritesh Patel
- Great Ormond Street Hospital , London , United Kingdom
| | - Olga Slater
- Great Ormond Street Hospital , London , United Kingdom
| | - Rehana Ahmed
- Nottingham Children's Hospital , Nottingham , United Kingdom
| | - Simon Bailey
- Great North Children's Hospital , Newcastle , United Kingdom
| | | | | | | | - Martin English
- Birmingham Children's Hospital , Birmingham , United Kingdom
| | - James Hayden
- Alderhey Children's Hospital , Liverpool , United Kingdom
| | - Lisa Howells
- Alderhey Children's Hospital , Liverpool , United Kingdom
| | - Ahmed Kamal
- Birmingham Children's Hospital , Birmingham , United Kingdom
| | - John Paul Kilday
- Royal Manchester Children's Hospital , Manchester , United Kingdom
| | - Stephen Lowis
- Bristol Children's Hospital , Bristol , United Kingdom
| | - Blanche Lumb
- Noah's Ark Children's Hospital Wales , Cardiff , United Kingdom
| | - Thomas Micic
- Noah's Ark Children's Hospital Wales , Cardiff , United Kingdom
| | - Dip Mitra
- Great North Children's Hospital , Newcastle , United Kingdom
| | - Erika Pace
- Royal Marsden Hospital , London , United Kingdom
| | - Susan Picton
- Leeds Children's Hospital , Leeds , United Kingdom
| | - Barry Pizer
- Alderhey Children's Hospital , Liverpool , United Kingdom
| | - Ayad Shafiq
- Great North Children's Hospit , Newcastle , United Kingdom
| | - Lena Uzunova
- Noah's Ark Children's Hospital Wales , Cardiff , United Kingdom
| | - Shaun Wilson
- John Radcliffe Hospital , Oxford , United Kingdom
| | - Harriet Wayman
- Royal Manchester Children's Hospital , Manchester , United Kingdom
| | | | - Enrico Opocher
- Great Ormond Street Hospital , London , United Kingdom
- Padua University Hospital , Padua , Italy
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3
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Izquierdo E, Carvalho DM, Mackay A, Temelso S, Boult JK, Pericoli G, Fernandez E, Das M, Molinari V, Grabovska Y, Rogers RF, Ajmone-Cat MA, Proszek PZ, Stubbs M, Depani S, O'Hare P, Yu L, Roumelioti G, Choudhary JS, Clarke M, Fairchild AR, Jacques TS, Grundy RG, Howell L, Picton S, Adamski J, Wilson S, Gray JC, Zebian B, Marshall LV, Carceller F, Grill J, Vinci M, Robinson SP, Hubank M, Hargrave D, Jones C. DIPG Harbors Alterations Targetable by MEK Inhibitors, with Acquired Resistance Mechanisms Overcome by Combinatorial Inhibition. Cancer Discov 2022; 12:712-729. [PMID: 34737188 PMCID: PMC7612484 DOI: 10.1158/2159-8290.cd-20-0930] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/04/2021] [Accepted: 10/19/2021] [Indexed: 11/16/2022]
Abstract
The survival of children with diffuse intrinsic pontine glioma (DIPG) remains dismal, with new treatments desperately needed. In a prospective biopsy-stratified clinical trial, we combined detailed molecular profiling and drug screening in newly established patient-derived models in vitro and in vivo. We identified in vitro sensitivity to MEK inhibitors in DIPGs harboring MAPK pathway alterations, but treatment of patient-derived xenograft models and a patient at relapse failed to elicit a significant response. We generated trametinib-resistant clones in a BRAFG469V model through continuous drug exposure and identified acquired mutations in MEK1/2 with sustained pathway upregulation. These cells showed hallmarks of mesenchymal transition and expression signatures overlapping with inherently trametinib-insensitive patient-derived cells, predicting sensitivity to dasatinib. Combined trametinib and dasatinib showed highly synergistic effects in vitro and on ex vivo brain slices. We highlight the MAPK pathway as a therapeutic target in DIPG and show the importance of parallel resistance modeling and combinatorial treatments for meaningful clinical translation. SIGNIFICANCE We report alterations in the MAPK pathway in DIPGs to confer initial sensitivity to targeted MEK inhibition. We further identify for the first time the mechanism of resistance to single-agent targeted therapy in these tumors and suggest a novel combinatorial treatment strategy to overcome it in the clinic. This article is highlighted in the In This Issue feature, p. 587.
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Affiliation(s)
- Elisa Izquierdo
- Division of Molecular Pathology, Institute of Cancer Research, London, United Kingdom
| | - Diana M. Carvalho
- Division of Molecular Pathology, Institute of Cancer Research, London, United Kingdom
| | - Alan Mackay
- Division of Molecular Pathology, Institute of Cancer Research, London, United Kingdom
| | - Sara Temelso
- Division of Molecular Pathology, Institute of Cancer Research, London, United Kingdom
| | - Jessica K.R. Boult
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Giulia Pericoli
- Department of Haematology/Oncology, Gene and Cell Therapy, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Elisabet Fernandez
- Division of Molecular Pathology, Institute of Cancer Research, London, United Kingdom
| | - Molina Das
- Division of Molecular Pathology, Institute of Cancer Research, London, United Kingdom
| | - Valeria Molinari
- Division of Molecular Pathology, Institute of Cancer Research, London, United Kingdom
| | - Yura Grabovska
- Division of Molecular Pathology, Institute of Cancer Research, London, United Kingdom
| | - Rebecca F. Rogers
- Division of Molecular Pathology, Institute of Cancer Research, London, United Kingdom
| | | | - Paula Z. Proszek
- Molecular Diagnostics, Royal Marsden Hospital NHS Trust, Sutton, United Kingdom
| | - Mark Stubbs
- Division of Cancer Therapeutics, Institute of Cancer Research, London, United Kingdom
| | - Sarita Depani
- Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Patricia O'Hare
- Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Lu Yu
- Division of Cancer Biology, Institute of Cancer Research, London, United Kingdom
| | - Georgia Roumelioti
- Division of Cancer Biology, Institute of Cancer Research, London, United Kingdom
| | - Jyoti S. Choudhary
- Division of Cancer Biology, Institute of Cancer Research, London, United Kingdom
| | - Matthew Clarke
- Division of Molecular Pathology, Institute of Cancer Research, London, United Kingdom
| | - Amy R. Fairchild
- UCL Great Ormond Street Institute for Child Health, London, United Kingdom
| | - Thomas S. Jacques
- UCL Great Ormond Street Institute for Child Health, London, United Kingdom
| | - Richard G. Grundy
- Children's Brain Tumour Research Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Lisa Howell
- Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Susan Picton
- Leeds Children's Hospital, Leeds, United Kingdom
| | - Jenny Adamski
- Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
| | - Shaun Wilson
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Juliet C. Gray
- Centre for Cancer Immunology, University of Southampton, Southampton, United Kingdom
| | - Bassel Zebian
- Department of Neurosurgery, Kings College Hospital NHS Trust, London, United Kingdom
| | - Lynley V. Marshall
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- Children & Young People's Unit, Royal Marsden Hospital NHS Trust, Sutton, United Kingdom
| | - Fernando Carceller
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
- Children & Young People's Unit, Royal Marsden Hospital NHS Trust, Sutton, United Kingdom
| | - Jacques Grill
- Department of Pediatric and Adolescent Oncology and INSERM Unit U891, Team “Genomics and Oncogenesis of Pediatric Brain Tumors,” Gustave Roussy and University Paris-Saclay, Villejuif, France
| | - Maria Vinci
- Department of Haematology/Oncology, Gene and Cell Therapy, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Simon P. Robinson
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Michael Hubank
- Molecular Diagnostics, Royal Marsden Hospital NHS Trust, Sutton, United Kingdom
| | - Darren Hargrave
- Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
- UCL Great Ormond Street Institute for Child Health, London, United Kingdom
| | - Chris Jones
- Division of Molecular Pathology, Institute of Cancer Research, London, United Kingdom
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4
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Kemps PG, Picarsic J, Durham BH, Hélias-Rodzewicz Z, Hiemcke-Jiwa L, van den Bos C, van de Wetering MD, van Noesel CJM, van Laar JAM, Verdijk RM, Flucke UE, Hogendoorn PCW, Woei-A-Jin FJSH, Sciot R, Beilken A, Feuerhake F, Ebinger M, Möhle R, Fend F, Bornemann A, Wiegering V, Ernestus K, Méry T, Gryniewicz-Kwiatkowska O, Dembowska-Baginska B, Evseev DA, Potapenko V, Baykov VV, Gaspari S, Rossi S, Gessi M, Tamburrini G, Héritier S, Donadieu J, Bonneau-Lagacherie J, Lamaison C, Farnault L, Fraitag S, Jullié ML, Haroche J, Collin M, Allotey J, Madni M, Turner K, Picton S, Barbaro PM, Poulin A, Tam IS, El Demellawy D, Empringham B, Whitlock JA, Raghunathan A, Swanson AA, Suchi M, Brandt JM, Yaseen NR, Weinstein JL, Eldem I, Sisk BA, Sridhar V, Atkinson M, Massoth LR, Hornick JL, Alexandrescu S, Yeo KK, Petrova-Drus K, Peeke SZ, Muñoz-Arcos LS, Leino DG, Grier DD, Lorsbach R, Roy S, Kumar AR, Garg S, Tiwari N, Schafernak KT, Henry MM, van Halteren AGS, Abla O, Diamond EL, Emile JF. ALK-positive histiocytosis: a new clinicopathologic spectrum highlighting neurologic involvement and responses to ALK inhibition. Blood 2022; 139:256-280. [PMID: 34727172 PMCID: PMC8759533 DOI: 10.1182/blood.2021013338] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/18/2021] [Indexed: 11/20/2022] Open
Abstract
ALK-positive histiocytosis is a rare subtype of histiocytic neoplasm first described in 2008 in 3 infants with multisystemic disease involving the liver and hematopoietic system. This entity has subsequently been documented in case reports and series to occupy a wider clinicopathologic spectrum with recurrent KIF5B-ALK fusions. The full clinicopathologic and molecular spectra of ALK-positive histiocytosis remain, however, poorly characterized. Here, we describe the largest study of ALK-positive histiocytosis to date, with detailed clinicopathologic data of 39 cases, including 37 cases with confirmed ALK rearrangements. The clinical spectrum comprised distinct clinical phenotypic groups: infants with multisystemic disease with liver and hematopoietic involvement, as originally described (Group 1A: 6/39), other patients with multisystemic disease (Group 1B: 10/39), and patients with single-system disease (Group 2: 23/39). Nineteen patients of the entire cohort (49%) had neurologic involvement (7 and 12 from Groups 1B and 2, respectively). Histology included classic xanthogranuloma features in almost one-third of cases, whereas the majority displayed a more densely cellular, monomorphic appearance without lipidized histiocytes but sometimes more spindled or epithelioid morphology. Neoplastic histiocytes were positive for macrophage markers and often conferred strong expression of phosphorylated extracellular signal-regulated kinase, confirming MAPK pathway activation. KIF5B-ALK fusions were detected in 27 patients, whereas CLTC-ALK, TPM3-ALK, TFG-ALK, EML4-ALK, and DCTN1-ALK fusions were identified in single cases. Robust and durable responses were observed in 11/11 patients treated with ALK inhibition, 10 with neurologic involvement. This study presents the existing clinicopathologic and molecular landscape of ALK-positive histiocytosis and provides guidance for the clinical management of this emerging histiocytic entity.
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Affiliation(s)
- Paul G Kemps
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jennifer Picarsic
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Benjamin H Durham
- Human Oncology and Pathogenesis Program, Department of Medicine, and
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Zofia Hélias-Rodzewicz
- Department of Pathology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne, France
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
| | | | - Cor van den Bos
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Emma Children's Hospital, and
| | - Marianne D van de Wetering
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Emma Children's Hospital, and
| | - Carel J M van Noesel
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jan A M van Laar
- Department of Internal Medicine and Immunology, and
- Section of Clinical Immunology, Department of Immunology, and
| | - Robert M Verdijk
- Department of Pathology, Erasmus Medical Center University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Uta E Flucke
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - F J Sherida H Woei-A-Jin
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | | | - Martin Ebinger
- Department I - General Pediatrics, Children's Hospital, Hematology and Oncology
| | | | - Falko Fend
- Department of Pathology and Neuropathology and Comprehensive Cancer Center, University Hospital Tuebingen, Tuebingen, Germany
| | - Antje Bornemann
- Department of Pathology and Neuropathology and Comprehensive Cancer Center, University Hospital Tuebingen, Tuebingen, Germany
| | - Verena Wiegering
- Department of Oncology, Hematology and Stem Cell Transplantation, University Children's Hospital Würzburg, Würzburg, Germany
| | - Karen Ernestus
- Department of Pathology, University of Würzburg and Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Tina Méry
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Klinikum Chemnitz, Chemnitz, Germany
| | | | | | - Dmitry A Evseev
- Dmitriy Rogachev National Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Vsevolod Potapenko
- Department of Hematology and Oncology, Municipal Educational Hospital N°31, Saint Petersburg, Russia
- Department of Bone Marrow Transplantation and
| | - Vadim V Baykov
- Department of Pathology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Stefania Gaspari
- Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children's Hospital Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Sabrina Rossi
- Pathology Unit, Laboratories Department, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | | | - Gianpiero Tamburrini
- Department of Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sébastien Héritier
- Department of Pediatric Hematology and Oncology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean Donadieu
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
- Department of Pediatric Hematology and Oncology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Claire Lamaison
- Department of Pathology, Rennes University Hospital, Rennes, France
| | - Laure Farnault
- Department of Hematology, La Conception, University Hospital of Marseille, Marseille, France
| | - Sylvie Fraitag
- Department of Pathology, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie-Laure Jullié
- Department of Pathology, University Hospital of Bordeaux, Bordeaux, France
| | - Julien Haroche
- Department of Internal Medicine, University Hospital La Pitié-Salpêtrière Paris, French National Reference Center for Histiocytoses, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Matthew Collin
- Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | | | - Majid Madni
- Department of Pediatric Hematology and Oncology, Nottingham University Hospitals, Nottingham, United Kingdom
| | | | - Susan Picton
- Department of Pediatric Oncology, Leeds Children's Hospital, Leeds, United Kingdom
| | - Pasquale M Barbaro
- Department of Hematology, Queensland Children's Hospital, Brisbane, QLD, Australia
| | - Alysa Poulin
- Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Ingrid S Tam
- Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Dina El Demellawy
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Brianna Empringham
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - James A Whitlock
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | | | - Amy A Swanson
- Division of Anatomic Pathology, Mayo Clinic Rochester, Rochester, MN
| | - Mariko Suchi
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI
| | - Jon M Brandt
- Department of Pediatric Oncology, Hospital Sisters Health System St Vincent Children's Hospital, Green Bay, WI
| | - Nabeel R Yaseen
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Joanna L Weinstein
- Department of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Irem Eldem
- Department of Pediatric Hematology and Oncology, St Louis Children's Hospital, Washington University in St Louis, St Louis, MO
| | - Bryan A Sisk
- Department of Pediatric Hematology and Oncology, St Louis Children's Hospital, Washington University in St Louis, St Louis, MO
| | - Vaishnavi Sridhar
- Department of Pediatric Hematology and Oncology, Carilion Children's Pediatric Hematology and Oncology, Roanoke, VA
| | - Mandy Atkinson
- Department of Pediatric Hematology and Oncology, Carilion Children's Pediatric Hematology and Oncology, Roanoke, VA
| | - Lucas R Massoth
- Department of Pathology, Massachusetts General Hospital, and
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Sanda Alexandrescu
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Department of Pathology, Boston Children's Hospital, Boston, MA
| | - Kee Kiat Yeo
- Department of Pediatric Oncology, Dana Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA
| | | | - Stephen Z Peeke
- Department of Hematology and Medical Oncology, Maimonides Medical Center, Brooklyn, NY
| | - Laura S Muñoz-Arcos
- Department of Internal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Daniel G Leino
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - David D Grier
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Robert Lorsbach
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Somak Roy
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Ashish R Kumar
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | | | | | | - Michael M Henry
- Center for Cancer and Blood Disorders, Phoenix Children's Hospital, Phoenix, AZ
| | - Astrid G S van Halteren
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands; and
| | - Oussama Abla
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Eli L Diamond
- Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Jean-François Emile
- Department of Pathology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne, France
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
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5
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Apps JR, Maycock S, Ellison DW, Jaspan T, Ritzmann TA, Macarthur D, Mallucci C, Wheatley K, Veal GJ, Grundy RG, Picton S. Phase II study of intravenous etoposide in patients with relapsed ependymoma (CNS 2001 04). Neurooncol Adv 2022; 4:vdac053. [PMID: 35591977 PMCID: PMC9113139 DOI: 10.1093/noajnl/vdac053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Relapsed ependymoma has a dismal prognosis, and the role of chemotherapy at relapse remains unclear. This study prospectively evaluated the efficacy of intensive intravenous (IV) etoposide in patients less than 21 years of age with relapsed intracranial ependymoma (NCT00278252). Methods This was a single-arm, open-label, phase II trial using Gehan's two-stage design. Patients received IV etoposide 100 mg/m2 on days 1-3, 8-10, and 15-17 of each 28-day cycle, up to maximum of 6 cycles. Primary outcome was radiological response after 3 cycles. Pharmacokinetic analysis was performed in 10 patients. Results Twenty-five patients were enrolled and included in the intention-to-treat (ITT) analysis. Three patients were excluded in per-protocol (PP) analysis. After 3 cycles of etoposide, 5 patients (ITT 20%/PP 23%) had a complete response (CR), partial response (PR), or objective response (OR). Nine patients (ITT 36%/PP 41%,) had a best overall response of CR, PR, or OR. 1-year PFS was 24% in ITT and 23% in PP populations. 1-year OS was 56% and 59%, 5-year OS was 20% and 18%, respectively, in ITT and PP populations. Toxicity was predominantly hematological, with 20/25 patients experiencing a grade 3 or higher hematological adverse event. Conclusions This study confirms the activity of IV etoposide against relapsed ependymoma, however, this is modest, not sustained, and similar to that with oral etoposide, albeit with increased toxicity. These results confirm the dismal prognosis of this disease, provide a rationale to include etoposide within drug combinations, and highlight the need to develop novel treatments for recurrent ependymoma.
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Affiliation(s)
- John R Apps
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Shanna Maycock
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - David W Ellison
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Timothy Jaspan
- Radiology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Timothy A Ritzmann
- Children’s Brain Tumour Research Centre, Bio-Discovery Institute and Queen’s Medical Centre, University of Nottingham, Nottingham, UK
| | - Donald Macarthur
- Children’s Brain Tumour Research Centre, Bio-Discovery Institute and Queen’s Medical Centre, University of Nottingham, Nottingham, UK
| | - Conor Mallucci
- Department of Neurosurgery, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
| | - Keith Wheatley
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Gareth J Veal
- Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| | - Richard G Grundy
- Children’s Brain Tumour Research Centre, Bio-Discovery Institute and Queen’s Medical Centre, University of Nottingham, Nottingham, UK
| | - Susan Picton
- Department of Paediatric Oncology, Leeds Children’s Hospital, The Leeds Teaching Hospitals NHS Trust, Leeds, UK
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6
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Mifsud M, Picton S, Ainsworth J. Bilateral retinal involvement in juvenile xanthogranuloma-Successful treatment with clofarabine. Pediatr Blood Cancer 2021; 68:e29222. [PMID: 34245213 DOI: 10.1002/pbc.29222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Maria Mifsud
- Department of Paediatric Oncology and Haematology, Royal Marsden Hospital, London, UK
| | - Susan Picton
- Department of Paediatric Oncology, Leeds Children's Hospital, Leeds, UK
| | - John Ainsworth
- Department of Paediatric Ophthalmology, Birmingham Children's Hospital, Birmingham, UK
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7
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Soon WC, Goacher E, Solanki S, Hayes J, Kapetanstrataki M, Picton S, Chumas PD, Mathew RK. The role of sex genotype in paediatric CNS tumour incidence and survival. Childs Nerv Syst 2021; 37:2177-2186. [PMID: 33950317 PMCID: PMC8263540 DOI: 10.1007/s00381-021-05165-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/12/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE Evidence exists, in CNS germinomas and medulloblastomas (MB), that patient sex significantly influences incidence and outcome. The role of sex genotype in other paediatric CNS tumours remains unclear. This study sought to examine the role of sex genotype in CNS tumour incidence and overall survival (OS). METHODS Age-adjusted incidence and OS rates were collected from the Surveillance Epidemiology and End Result (SEER) registry between 2000 and 2011 for common paediatric (<=19 years) CNS tumours: pilocytic astrocytoma (PA), anaplastic astrocytoma, glioblastoma (GBM), medulloblastoma, supratentorial CNS embryonal tumour, ependymoma, and germinoma. All patients with histologically confirmed, ICD-03 coded, first tumours, were included. Kaplan-Meier and Cox regression analyses were used to calculate hazard ratios (HR). RESULTS The total cases are as follows: males=3018 and females=2276. Highest incidence was seen in PA (n=2103). GBM displayed the worst OS, whilst PA displayed the best. Higher incidence was observed in males for all tumours, except PA. Females with ependymoma had significantly better OS compared to males, whereas males with germinomas had better OS compared to females. Females <1 year with AA had better OS than males. Increasing age significantly improved male and female survival in ependymoma and medulloblastoma. CONCLUSION Interrogating population-based registries such as SEER minimises bias and provides credible data. Observed differences in incidence and OS between the sexes for different paediatric CNS tumours provide useful prognostic information for clinicians. Sex genotype was a significant independent prognostic factor in ependymomas and germinomas. Further investigation of possible epigenetic and hormonal differences may provide sex-specific vulnerabilities that may be exploitable for targeted therapy.
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Affiliation(s)
- Wai Cheong Soon
- grid.415490.d0000 0001 2177 007XDepartment of Neurosurgery, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2TH UK
| | - Edward Goacher
- grid.416126.60000 0004 0641 6031Department of Neurosurgery, Royal Hallamshire Hospital, Glossop Road, Sheffield, England S10 2JF UK
| | - Sandeep Solanki
- grid.412570.50000 0004 0400 5079Department of Neurosurgery, University Hospital Coventry and Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX UK
| | - Josie Hayes
- grid.443984.6Leeds Genetics Laboratory, St. James’s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF UK
| | - Melpo Kapetanstrataki
- grid.9909.90000 0004 1936 8403School of Medicine, University of Leeds, Leeds, LS2 9JT UK
| | - Susan Picton
- grid.418161.b0000 0001 0097 2705Department of Paediatric Neuro-Oncology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Great George Street, Leeds, England LS1 3EX UK
| | - Paul Dominic Chumas
- Department of Neurosurgery, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Great George Street, Leeds, LS1 3EX, UK.
| | - Ryan Koshy Mathew
- School of Medicine, University of Leeds, Leeds, LS2 9JT, UK. .,Department of Neurosurgery, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Great George Street, Leeds, LS1 3EX, UK.
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8
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Eckstein OS, Nuchtern JG, Mallory GB, Guillerman RP, Musick MA, Barclay M, Bhatt JM, Davies P, Grundy RG, Martin A, Hilliard T, Lowis SP, Picton S, Nanduri V, Visser J, Allen CE, McClain KL. Management of severe pulmonary Langerhans cell histiocytosis in children. Pediatr Pulmonol 2020; 55:2074-2081. [PMID: 32511892 PMCID: PMC7771630 DOI: 10.1002/ppul.24822] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/21/2020] [Accepted: 05/06/2020] [Indexed: 01/17/2023]
Abstract
Patients with pulmonary Langerhans cell histiocytosis (LCH) typically have a benign course but may have extensive cystic lung disease with rare life-threatening complications including multiple and recurrent pneumothoraces and respiratory failure. We report seven severely affected pediatric patients treated with chemotherapy, aggressive chest tube management, and pleurodesis of whom five survived. Patients with extraordinary amounts of pulmonary cystic disease and multiple pneumothoraces due to LCH can have remarkable, curative outcomes with early recognition, optimal LCH-directed therapy, and supportive care.
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Affiliation(s)
- Olive S Eckstein
- Department of Pediatrics, Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, Texas.,Division of Pediatric Hematology-Oncology, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Jed G Nuchtern
- Division of Pediatric Surgery, Texas Children's Hospital, Houston, Texas.,Michael E. DeBakey Department of Pediatric Surgery, Baylor College of Medicine, Houston, Texas
| | - George B Mallory
- Division of Pulmonology, Texas Children's Hospital, Houston, Texas
| | - R Paul Guillerman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, Texas
| | - Matthew A Musick
- Section of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Mhairi Barclay
- Department of Paediatric Respiratory Medicine, Nottingham University Hospitals, Nottingham, UK
| | - Jayesh M Bhatt
- Department of Paediatric Respiratory Medicine, Nottingham University Hospitals, Nottingham, UK
| | - Patrick Davies
- Department of Paediatric Intensive Care, Nottingham University Hospitals, Nottingham, UK
| | - Richard G Grundy
- Department of Paediatric Oncology, Nottingham University Hospitals, Nottingham, UK
| | - Alice Martin
- Department of Paediatric Intensive Care, Bristol Children's Hospital, Bristol, UK
| | - Tom Hilliard
- Department of Paediatric Respiratory Medicine, Bristol Children's Hospital, Bristol, UK
| | - Stephen P Lowis
- Department of Paediatric Oncology, Bristol Royal Hospital for Children, Bristol, UK
| | - Susan Picton
- Department of Paediatric Oncology, Leeds Children's Hospital, Leeds, UK
| | - Vasanta Nanduri
- Department of Paediatrics, Watford General Hospital, Watford, UK
| | - Johannes Visser
- Department of Paediatric Oncology, Addenbrookes Hospital, Cambridge University Hospitals, Cambridge, UK
| | - Carl E Allen
- Department of Pediatrics, Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, Texas.,Division of Pediatric Hematology-Oncology, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Kenneth L McClain
- Department of Pediatrics, Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, Texas.,Division of Pediatric Hematology-Oncology, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
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Affiliation(s)
| | - Lea Solman
- Department of Dermatology, Chapel Allerton Hospital, Leeds, UK
| | - Bipin Mathew
- Department of Cellular Pathology, St James's Hospital, Leeds, UK
| | - Gayle Taylor
- Department of Dermatology, Chapel Allerton Hospital, Leeds, UK
| | - Sheila Clark
- Department of Dermatology, Chapel Allerton Hospital, Leeds, UK
| | - Susan Picton
- Department of Paediatric Oncology and Haematology, Leeds General Infirmary, Leeds, UK
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10
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Wilson JRF, Saeed F, Tyagi AK, Goodden JR, Sivakumar G, Crimmins D, Elliott M, Picton S, Chumas PD. Pre-operative neutrophil count and neutrophil-lymphocyte count ratio (NLCR) in predicting the histological grade of paediatric brain tumours: a preliminary study. Acta Neurochir (Wien) 2018; 160:793-800. [PMID: 29188366 PMCID: PMC5859055 DOI: 10.1007/s00701-017-3388-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 10/31/2017] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The neutrophil-lymphocyte count ratio (NLCR) is an established prognostic marker for renal, lung and colorectal carcinomas and has been suggested to be predictive of histological grade and outcome in adult intracranial tumours. The purpose of this study was to determine whether a correlation of the pre-operative neutrophil count (NC) and NLCR with the final histological grade exists in paediatric intracranial tumours. METHODS A retrospective analysis was undertaken at a single centre. Patients less than 18 years old at the time of surgery who underwent tumour-related procedures from 2006 to 2015 were included. Patients with recurrent tumours, previous bone marrow transplant and metastases were excluded. Pre-operative full blood counts (FBC), collected before the diagnosis of intracranial pathology and before administration of steroids, were matched with histological diagnosis for each patient. Post-operative FBC was also recorded, together with survival data where applicable. RESULTS A total of 116 patients (74 male, 42 female; mean age, 8 ± 0.9 years) with a diagnosis of primary intracranial tumours had pre-operative FBC that could be matched to final histological grade. Pre-operative NC and NLCR were higher with increasing grade of tumour: grade 1 (NC 4.29 109/l, NLCR 2.26), grade 2 (NC 4.59 109/l, NLCR 2.38), grade 3 (NC 5.67 109/l, NLCR 2.72) and grade 4 (NC 6.59 109/l, NLCR 3.31). Patients with WHO grade 1 and 2 tumours pooled together had a lower NC (4.37 95% CI ± 0.67 109/l) compared to WHO grade 3 and 4 patients (6.41 95% CI ± 0.99 109/l, p = 0.0013). The NLCR was lower in grade 1 and 2 tumours (2.29 ± 0.59) (compared to grade 3 and 4 tumours; 3.20 ± 0.76) but this did not reach significance (p = 0.069). The subgroup of patients with pilocytic astrocytoma had a significantly lower NC when compared to patients with high-grade tumours (p = 0.005). Medulloblastoma and supratentorial PNET subgroups had significantly higher NC compared to the low-grade group (p = 0.033, p = 0.002). Post-operative NC was significantly higher in the high-grade tumours (p = 0.034), but no difference was observed for NLCR (p = 0.28). CONCLUSIONS No evidence exists to support the correlation of pre-operative NC or NLCR to histological diagnosis in paediatric intracranial tumours. Our results indicate that a higher pre-operative NC/NLCR correlates with a higher histological grade of tumour. This suggests that immunological mechanisms may be involved in the pathogenesis of paediatric brain tumours, and a further prospective study is required to substantiate and expand these findings.
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Affiliation(s)
- J R F Wilson
- Department of Neurosurgery, The General Infirmary at Leeds, Leeds, LS13EX, UK.
| | - F Saeed
- Department of Neurosurgery, The General Infirmary at Leeds, Leeds, LS13EX, UK
| | - A K Tyagi
- Department of Neurosurgery, The General Infirmary at Leeds, Leeds, LS13EX, UK
| | - J R Goodden
- Department of Neurosurgery, The General Infirmary at Leeds, Leeds, LS13EX, UK
| | - G Sivakumar
- Department of Neurosurgery, The General Infirmary at Leeds, Leeds, LS13EX, UK
| | - D Crimmins
- Department of Neurosurgery, Beaumont Hospital, Dublin, Ireland
| | - M Elliott
- Department of Paediatric Oncology and Haematology, Leeds Children's Hospital, Leeds General Infirmary, Leeds, LS13EX, UK
| | - S Picton
- Department of Paediatric Oncology and Haematology, Leeds Children's Hospital, Leeds General Infirmary, Leeds, LS13EX, UK
| | - P D Chumas
- Department of Neurosurgery, The General Infirmary at Leeds, Leeds, LS13EX, UK
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11
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Falzon K, Drimtzias E, Picton S, Simmons I. Visual outcomes after chemotherapy for optic pathway glioma in children with and without neurofibromatosis type 1: results of the International Society of Paediatric Oncology (SIOP) Low-Grade Glioma 2004 trial UK cohort. Br J Ophthalmol 2018; 102:1367-1371. [DOI: 10.1136/bjophthalmol-2017-311305] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 12/24/2017] [Accepted: 12/29/2017] [Indexed: 02/04/2023]
Abstract
AimsTo report visual acuity (VA) outcomes following chemotherapy for optic pathway glioma (OPG) in children with or without neurofibromatosis type-1 (NF1) and to analyse associated risk factors.MethodsA prospective, multicentre, cohort study involving 155 children treated between September 2004 and December 2012. Initial and final VA was used for per-eye and per-subject analysis. Correlation tests were performed to determine whether initial VA predicted final VA. Logistic regression was used to determine whether age and tumour location were associated risk factors.Results90 children had complete ophthalmological data. At initiation of chemotherapy, 26% and 49% of eyes with NF1-OPG and sporadic OPG, respectively, had VA of ≥0.7 log of the minimum angle of resolution (logMAR). At final visit, per eye, 49% had ≤0.2, 23% had 0.30–0.60 and 28% had VA≥0.70 logMAR in the NF1-OPG group. In the sporadic OPG group, per eye, 32% had ≤0.2, 11% had VA 0.30–0.60 and 57% had ≥0.70 logMAR. Children with sporadic OPG, per eye, were significantly less likely to have VA outcomes ≤0.60 logMAR compared with children with NF1-OPG (OR=0.30; 95% CI 0.16 to 0.56; P<0.0001). Per subject, VA improved in 24%, remained stable in 35% and worsened in 41% of children with NF1-OPG and improved in 18%, remained stable in 43% and worsened in 39% of children with sporadic OPG.ConclusionsChildren with and without NF1 demonstrated the same rate of VA improvement, stabilisation or worsening; however, children with sporadic OPG had a poorer VA outcome. Better initial VA, older age, absence of postchiasm tumour and presence of NF1 were associated with improved or stable VA outcomes.
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12
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Gnekow AK, Walker DA, Kandels D, Picton S, Giorgio Perilongo, Grill J, Stokland T, Sandstrom PE, Warmuth-Metz M, Pietsch T, Giangaspero F, Schmidt R, Faldum A, Kilmartin D, De Paoli A, De Salvo GL. A European randomised controlled trial of the addition of etoposide to standard vincristine and carboplatin induction as part of an 18-month treatment programme for childhood (≤16 years) low grade glioma - A final report. Eur J Cancer 2017; 81:206-225. [PMID: 28649001 PMCID: PMC5517338 DOI: 10.1016/j.ejca.2017.04.019] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 03/23/2017] [Accepted: 04/18/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND The use of chemotherapy to manage newly diagnosed low grade glioma (LGG) was first introduced in the 1980s. One randomised trial has studied two- versus four-drug regimens with a duration of 12 months of treatment after resection. METHODS Within the European comprehensive treatment strategy for childhood LGG, the International Society of Paediatric Oncology-Low Grade Glioma (SIOP LGG) Committee launched a randomised trial involving 118 institutions and 11 countries to investigate the addition of etoposide (100 mg/m2, days 1, 2 & 3) to a four-course induction of vincristine (1.5 mg/m2 × 10 wkly) and carboplatin (550 mg/m2 q 3 weekly) as part of 18-month continuing treatment programme. Patients were recruited after imaging diagnosis, resection or biopsy with progressive disease/symptoms. Some 497 newly diagnosed patients (M/F 231/266; median age 4.26 years (interquartile range (IQR) 2.02-7.06)) were randomised to receive vincristine carboplatin (VC) (n = 249) or VC plus etoposide (VCE) during induction (n = 248), stratified by age and tumour site. FINDINGS No differences between the two arms were found in term of survival and radiological response. Response and non-progression rates at 24 weeks for VC and VCE, were 46% versus 41%, and 93% versus 91% respectively; 5-year Progression-Free Survival (PFS) and Overall Survival (OS) were 46% (StDev 3.5) versus 45% (StDev 3.5) and 89% (StDev 2.1) versus 89% (StDev 2.1) respectively. Age and diencephalic syndrome are adverse clinical risk factors for PFS and OS. 5-year OS for patients in early progression at week 24 were 46% (StDev 13.8) and 49% (StDev 16.5) in the two arms, respectively. INTERPRETATION The addition of etoposide to VC did not improve PFS or OS. High non-progression rates at 24 weeks justify retaining VC as standard first-line therapy. Infants with diencephalic syndrome and early progression need new treatments to be tested. Future trials should use neurological/visual and toxicity outcomes and be designed to discriminate between the impact on disease outcomes of 'duration of therapy' and 'age at stopping therapy'.
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Affiliation(s)
- Astrid K Gnekow
- Swabian Children's Cancer Center, Klinikum Augsburg, Germany
| | - David A Walker
- Children's Brain Tumour Research Centre, University of Nottingham, UK.
| | - Daniela Kandels
- Children's Brain Tumour Research Centre, University of Nottingham, UK
| | | | | | | | | | | | | | | | - Felice Giangaspero
- Department of Radiological, Oncological and Anatomo-pathological Sciences, University Sapienza Rome, Rome, Italy; IRCCS Neuromed, Pozzilli, Italy
| | - René Schmidt
- Institute of Biostatistics and Clinical Research, University of Muenster, Germany
| | - Andreas Faldum
- Institute of Biostatistics and Clinical Research, University of Muenster, Germany
| | - Denise Kilmartin
- Clinical Trials and Biostatistics Unit, IRCCS Istituto Oncologico Veneto, Padova, Italy
| | - Angela De Paoli
- Clinical Trials and Biostatistics Unit, IRCCS Istituto Oncologico Veneto, Padova, Italy
| | - Gian Luca De Salvo
- Clinical Trials and Biostatistics Unit, IRCCS Istituto Oncologico Veneto, Padova, Italy
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Cockle JV, Brüning-Richardson A, Scott KJ, Thompson J, Kottke T, Morrison E, Ismail A, Carcaboso AM, Rose A, Selby P, Conner J, Picton S, Short S, Vile R, Melcher A, Ilett E. Oncolytic Herpes Simplex Virus Inhibits Pediatric Brain Tumor Migration and Invasion. Mol Ther Oncolytics 2017; 5:75-86. [PMID: 28547002 PMCID: PMC5435599 DOI: 10.1016/j.omto.2017.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 04/25/2017] [Indexed: 12/13/2022] Open
Abstract
Pediatric high-grade glioma (pHGG) and diffuse intrinsic pontine glioma (DIPG) are invasive tumors with poor survival. Oncolytic virotherapy, initially devised as a direct cytotoxic treatment, is now also known to act via immune-mediated mechanisms. Here we investigate a previously unreported mechanism of action: the inhibition of migration and invasion in pediatric brain tumors. We evaluated the effect of oncolytic herpes simplex virus 1716 (HSV1716) on the migration and invasion of pHGG and DIPG both in vitro using 2D (scratch assay, live cell imaging) and 3D (spheroid invasion in collagen) assays and in vivo using an orthotopic xenograft model of DIPG invasion. HSV1716 inhibited migration and invasion in pHGG and DIPG cell lines. pHGG cells demonstrated reduced velocity and changed morphology in the presence of virus. HSV1716 altered pHGG cytoskeletal dynamics by stabilizing microtubules, inhibiting glycogen synthase kinase-3, and preventing localized clustering of adenomatous polyposis coli (APC) to the leading edge of cells. HSV1716 treatment also reduced tumor infiltration in a mouse orthotopic xenograft DIPG model. Our results demonstrate that HSV1716 targets the migration and invasion of pHGG and DIPG and indicates the potential of an oncolytic virus (OV) to be used as a novel anti-invasive treatment strategy for pediatric brain tumors.
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Affiliation(s)
- Julia V. Cockle
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS9 7TF, UK
- Yorkshire Regional Centre for Paediatric Oncology and Haematology, Leeds General Infirmary, Leeds LS1 3EX, UK
| | | | - Karen J. Scott
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS9 7TF, UK
| | - Jill Thompson
- Department of Immunology, Mayo Clinic, Rochester, MN 55905, USA
| | - Timothy Kottke
- Department of Immunology, Mayo Clinic, Rochester, MN 55905, USA
| | - Ewan Morrison
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds LS9 7TF, UK
| | - Azam Ismail
- Department of Pathology, St. James’s University Hospital, Leeds LS9 7TF, UK
| | | | - Ailsa Rose
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS9 7TF, UK
| | - Peter Selby
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS9 7TF, UK
| | | | - Susan Picton
- Yorkshire Regional Centre for Paediatric Oncology and Haematology, Leeds General Infirmary, Leeds LS1 3EX, UK
| | - Susan Short
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS9 7TF, UK
| | - Richard Vile
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS9 7TF, UK
- Department of Immunology, Mayo Clinic, Rochester, MN 55905, USA
| | - Alan Melcher
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS9 7TF, UK
- Institute of Cancer Research, London SM2 5NG, UK
| | - Elizabeth Ilett
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS9 7TF, UK
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Hassan H, Pinches A, Picton S, McGuire W, Phillips R. HG-39SURVIVAL RATES AND PROGNOSTIC OUTCOMES OF HIGH GRADE BRAIN STEM GLIOMAS IN CHILDHOOD: A SYSTEMATIC REVIEW AND META-ANALYSIS. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now073.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Drimtzias E, Picton S, Gormley J, Falzon K, Simmons I. LG-04VISUAL OUTCOMES IN CHILDREN TREATED WITH CHEMOTHERAPY FOR OPTIC PATHWAY GLIOMA IN THE SIOP LGG 2004: RESULTS FROM THE UK MULTICENTER STUDY. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now075.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Vivekanandan S, Breene R, Ramanujachar R, Traunecker H, Pizer B, Gaze MN, Saran F, Thorp N, English M, Wheeler K, Michalski A, Walker DA, Saunders D, Cowie F, Cameron A, Picton S, Parashar D, Horan G, Williams MV. Reply to Comment on: The UK Experience of a Treatment Strategy for Pediatric Metastatic Medulloblastoma Comprising Intensive Induction Chemotherapy, Hyperfractionated Accelerated Radiotherapy, and Response-Directed High-Dose Myeloablative Chemotherapy or Maintenance Chemotherapy (Milan Strategy). Pediatr Blood Cancer 2016; 63:1125-6. [PMID: 26891280 DOI: 10.1002/pbc.25946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 01/20/2016] [Indexed: 11/09/2022]
Affiliation(s)
| | - R Breene
- Paediatric Oncology, Cambridge University Hospitals NHS Foundation Trust Addenbrooke's Hospital, Cambridge, UK
| | - R Ramanujachar
- Paediatric Oncology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - H Traunecker
- Paediatric Oncology, Children's Hospital for Wales, Cardiff, UK
| | - B Pizer
- Paediatric Oncology, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK
| | - M N Gaze
- Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - F Saran
- Clinical Oncology, The Royal Marsden NHS Foundation Trust, Surrey, UK
| | - N Thorp
- Clinical Oncology, The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK
| | - M English
- Paediatric Oncology, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - K Wheeler
- Paediatric Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - A Michalski
- Paediatric Oncology, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
| | - D A Walker
- Paediatric Oncology, Nottingham Children's Hospital University of Nottingham, Nottingham, UK
| | - D Saunders
- Clinical Oncology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - F Cowie
- Clinical Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - A Cameron
- Clinical Oncology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - S Picton
- Paediatric Oncology, The Leeds Teaching Hospitals, Leeds, UK
| | - D Parashar
- Cancer Research Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - G Horan
- Clinical Oncology, Cambridge University Hospitals NHS Foundation Trust Addenbrooke's Hospital, Cambridge, UK
| | - M V Williams
- Clinical Oncology, Cambridge University Hospitals NHS Foundation Trust Addenbrooke's Hospital, Cambridge, UK
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Guy D, Simmons I, Picton S. NU-09THE VALUE OF ORTHOPTIC LEAD FOR PAEDIATRIC ONCOLOGY OPHTHALMOLOGY CLINICS. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now079.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Drimtzias E, Picton S, Richards D, Falzon K, Hoole J, Simmons I. LG-28THREAT TO VISION SCORE (TTV SCORE) IN CHILDREN WITH OPTIC PATHWAY GLIOMAS (OPGS): UK EXPERIENCE FROM PROSPECTIVE LOW GRADE GLIOMA (LGG2) TRIAL. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now075.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cockle J, Ilett E, Brüning-Richardson A, Thompson J, Kottke T, Scott K, Morrison E, Ismail A, Rose A, Picton S, Vile R, Selby P, Short S, Melcher A. HG-08ONCOLYTIC HERPES SIMPLEX VIRUS: AN ANTI-INVASIVE THERAPEUTIC STRATEGY FOR PAEDIATRIC HIGH GRADE GLIOMA AND DIFFUSE INTRINSIC PONTINE GLIOMA. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now073.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Morgan JE, McKeever K, Tyerman KS, Henderson M, Picton S, Phillips RS. Aminoaciduria in the prediction of ifosfamide-induced tubulopathy after childhood cancer: a feasibility study. Pilot Feasibility Stud 2016; 2:4. [PMID: 27965825 PMCID: PMC5154030 DOI: 10.1186/s40814-015-0040-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 12/03/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Ifosfamide, an alkylating agent used widely in the treatment of childhood malignancy, can cause many side effects including a proximal tubulopathy. Studies suggest that aminoaciduria is seen most commonly of all the biochemical abnormalities of ifosfamide-induced tubulopathy. A recent systematic review has found a paucity of data regarding the value of early markers indicating clinically significant tubulopathy. We undertook a pilot study to determine the feasibility of examining whether patients can be risk-stratified on the basis of aminoaciduria for the development of future significant ifosfamide-induced tubulopathy, to allow the evolution of appropriate follow-up strategies. We also aimed to define accrual rates, costs and clinical demands for a future larger study. METHODS This observational study recruited 21 patients from the Leeds Paediatric Oncology service. The medical notes of each patient were reviewed for demographic and clinical data. Simultaneous samples of blood and urine were obtained. RESULTS The investigations in the feasibility study were acceptable to patients and were minimally demanding on both clinical and laboratory staff. Financially, the cost per patient was minimal. This study was not powered to detect significant associations with TmP/GFR (ratio of renal tubular maximum reabsorption rate of phosphate to glomerular filtration rate), growth and electrolyte supplementation. However, all patients with minimal aminoaciduria (≤2 elevated urinary amino acids) had normal TmP/GFR and no need for electrolyte supplementation. CONCLUSIONS This pilot study has shown that a larger study is feasible and may provide clinically useful data to change current practice. This should aim to establish whether the number of abnormal amino acids or the degree of abnormality is most significant in predicting clinically significant proximal tubulopathy.
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Affiliation(s)
- Jessica E. Morgan
- Department of Paediatric Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK ,Centre for Reviews and Dissemination, University of York, Leeds, UK
| | - Karl McKeever
- Department of Paediatric Nephrology, Royal Belfast Hospital for Sick Children, Leeds, UK
| | - Kay S. Tyerman
- Department of Paediatric Nephrology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Michael Henderson
- Department of Biochemical Genetics, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Susan Picton
- Department of Paediatric Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Robert S. Phillips
- Department of Paediatric Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK ,Centre for Reviews and Dissemination, University of York, Leeds, UK
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Cockle JV, Ilett E, Brüning-Richardson A, Scott K, Picton S, Short S, Melcher A. OP03ONCOLYTIC HERPES SIMPLEX VIRUS INHIBITS PAEDIATRIC HIGH GRADE GLIOMA AND DIFFUSE INTRINSIC PONTINE GLIOMA MIGRATION AND INVASION; MECHANISM AND POTENTIAL FOR CLINICAL APPLICATION. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov283.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Uday S, Murray RD, Picton S, Chumas P, Raju M, Chandwani M, Alvi S. Endocrine sequelae beyond 10 years in survivors of medulloblastoma. Clin Endocrinol (Oxf) 2015; 83:663-70. [PMID: 25952583 DOI: 10.1111/cen.12815] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 11/23/2014] [Accepted: 05/04/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Survival following treatment of paediatric medulloblastomas has significantly improved over the past few decades, but as a consequence, late effects, particularly endocrine sequelae, have been recognized. The complete picture of late effects, however, has been limited by short duration of follow-up. AIM To establish the evolution of endocrine sequelae in patients treated for medulloblastoma. METHODS Single-centre analysis of medulloblastoma treatment and endocrine sequelae in patients diagnosed between 1982 and 2002. RESULTS A total of 109 patients were treated for medulloblastoma, with various treatment modalities involving radio- and chemotherapy. Only 45 (41%) patients remained alive, and details of treatment and late effects were available for 35 (25 m). The median age at diagnosis was 8 (range 2-14) years, and the median follow-up was 18 (range 10-28) years. Growth hormone deficiency (GHD) was the most prevalent hormone deficiency (97%), followed by primary hypothyroidism (60%) and adrenocorticotrophic hormone (ACTH) deficiency (45·5%). The median time from end of treatment to loss of growth hormone was 1·7 (range 0·7-15) years, ACTH deficiency 2·9 (range 0·75-7·5) years and hypothyroidism 4·1 (range 0·7-11·4) years. Twenty-three percentage developed hypogonadism (17% primary and 6% secondary), whilst precocious puberty was seen in 20%. Endocrinopathies appeared to be more prevalent in those treated with concomitant chemotherapy and radiotherapy. CONCLUSIONS Prevalence of endocrine sequelae in medulloblastoma survivors is high, and evolution of endocrine dysfunction can occur as late as 15 years from treatment completion; hence, long-term close monitoring of growth, puberty and gonadal function is essential.
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Affiliation(s)
- Suma Uday
- Paediatric Endocrinology, Leeds Children's Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Robert D Murray
- Endocrinology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Susan Picton
- Paediatric Oncology & Haematology, Leeds Children's Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Paul Chumas
- Neurosurgery, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Midhu Raju
- Paediatric Oncology & Haematology, Leeds Children's Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Manju Chandwani
- General Paediatrics, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Sabah Alvi
- Paediatric Endocrinology, Leeds Children's Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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23
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Veal GJ, Errington J, Hayden J, Hobin D, Murphy D, Dommett RM, Tweddle DA, Jenkinson H, Picton S. Carboplatin therapeutic monitoring in preterm and full-term neonates. Eur J Cancer 2015; 51:2022-30. [PMID: 26232270 PMCID: PMC4571926 DOI: 10.1016/j.ejca.2015.07.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 05/12/2015] [Accepted: 07/13/2015] [Indexed: 11/17/2022]
Abstract
Introduction Administration of the most appropriate dose of chemotherapy to neonates is particularly challenging and frequently not standardised based on any scientific rationale. We report the clinical utility of carboplatin therapeutic drug monitoring in preterm and full-term neonates within the first month of life. Methods Carboplatin therapeutic monitoring was performed to achieve target drug exposures area under the plasma concentration–time curve (AUC values) in nine preterm and full-term neonates diagnosed with retinoblastoma or neuroblastoma treated over an 8 year period. Carboplatin was administered over 3 days with therapeutic drug monitoring utilised to target cumulative AUC values of 5.2–7.8 mg/ml min. Results AUC values achieved were within 15% of target values for the individual courses of treatment in all but one patient (12/13 courses of treatment), with dose modifications of up to 215% required to achieve target AUC values, based on initial mg/kg dosing schedules. Carboplatin clearance determined across three consecutive chemotherapy courses in two patients increased from 3.4 to 7.1 ml/min and from 7.2 to 16.5 ml/min, representing increases of 210–230% over several weeks of treatment. Complete remission was observed in 8/9 patients, with no renal toxicity reported and only one patient experiencing ototoxicity. Conclusion The study highlights the benefits of utilising therapeutic drug monitoring to achieve target carboplatin AUC values in preterm and full-term neonates treated within the first few weeks of life, particularly in view of marked increases in drug clearance observed over consecutive chemotherapy courses. In the absence of therapeutic drug monitoring, body-weight based dosing is recommended, with dosing guidance provided for both approaches to inform future treatment.
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Affiliation(s)
- Gareth J Veal
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
| | - Julie Errington
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - James Hayden
- Alder Hey Children's NHS Trust, Liverpool L12 2AP, UK
| | - David Hobin
- Birmingham Children's Hospital, Birmingham B4 6NH, UK
| | - Dermot Murphy
- Royal Hospital for Sick Children, Glasgow G3 8SJ, UK
| | | | - Deborah A Tweddle
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; Great North Children's Hospital, Newcastle upon Tyne NE1 4LP, UK
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Bielack SS, Smeland S, Whelan JS, Marina N, Jovic G, Hook JM, Krailo MD, Gebhardt M, Pápai Z, Meyer J, Nadel H, Randall RL, Deffenbaugh C, Nagarajan R, Brennan B, Letson GD, Teot LA, Goorin A, Baumhoer D, Kager L, Werner M, Lau CC, Sundby Hall K, Gelderblom H, Meyers P, Gorlick R, Windhager R, Helmke K, Eriksson M, Hoogerbrugge PM, Schomberg P, Tunn PU, Kühne T, Jürgens H, van den Berg H, Böhling T, Picton S, Renard M, Reichardt P, Gerss J, Butterfass-Bahloul T, Morris C, Hogendoorn PC, Seddon B, Calaminus G, Michelagnoli M, Dhooge C, Sydes MR, Bernstein M. Methotrexate, Doxorubicin, and Cisplatin (MAP) Plus Maintenance Pegylated Interferon Alfa-2b Versus MAP Alone in Patients With Resectable High-Grade Osteosarcoma and Good Histologic Response to Preoperative MAP: First Results of the EURAMOS-1 Good Response Randomized Controlled Trial. J Clin Oncol 2015; 33:2279-87. [PMID: 26033801 PMCID: PMC4486345 DOI: 10.1200/jco.2014.60.0734] [Citation(s) in RCA: 270] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE EURAMOS-1, an international randomized controlled trial, investigated maintenance therapy with pegylated interferon alfa-2b (IFN-α-2b) in patients whose osteosarcoma showed good histologic response (good response) to induction chemotherapy. PATIENTS AND METHODS At diagnosis, patients age ≤ 40 years with resectable high-grade osteosarcoma were registered. Eligibility after surgery for good response random assignment included ≥ two cycles of preoperative MAP (methotrexate, doxorubicin, and cisplatin), macroscopically complete surgery of primary tumor, < 10% viable tumor, and no disease progression. These patients were randomly assigned to four additional cycles MAP with or without IFN-α-2b (0.5 to 1.0 μg/kg per week subcutaneously, after chemotherapy until 2 years postregistration). Outcome measures were event-free survival (EFS; primary) and overall survival and toxicity (secondary). RESULTS Good response was reported in 1,041 of 2,260 registered patients; 716 consented to random assignment (MAP, n = 359; MAP plus IFN-α-2b, n = 357), with baseline characteristics balanced by arm. A total of 271 of 357 started IFN-α-2b; 105 stopped early, and 38 continued to receive treatment at data freeze. Refusal and toxicity were the main reasons for never starting IFN-α-2b and for stopping prematurely, respectively. Median IFN-α-2b duration, if started, was 67 weeks. A total of 133 of 268 patients who started IFN-α-2b and provided toxicity information reported grade ≥ 3 toxicity during IFN-α-2b treatment. With median follow-up of 44 months, 3-year EFS for all 716 randomly assigned patients was 76% (95% CI, 72% to 79%); 174 EFS events were reported (MAP, n = 93; MAP plus IFN-α-2b, n = 81). Hazard ratio was 0.83 (95% CI, 0.61 to 1.12; P = .214) from an adjusted Cox model. CONCLUSION At the preplanned analysis time, MAP plus IFN-α-2b was not statistically different from MAP alone. A considerable proportion of patients never started IFN-α-2b or stopped prematurely. Long-term follow-up for events and survival continues.
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Affiliation(s)
- Stefan S. Bielack
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Sigbjørn Smeland
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Jeremy S. Whelan
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Neyssa Marina
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Gordana Jovic
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Jane M. Hook
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Mark D. Krailo
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Mark Gebhardt
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Zsuzsanna Pápai
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - James Meyer
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Helen Nadel
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - R. Lor Randall
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Claudia Deffenbaugh
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Rajaram Nagarajan
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Bernadette Brennan
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - G. Douglas Letson
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Lisa A. Teot
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Allen Goorin
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Daniel Baumhoer
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Leo Kager
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Mathias Werner
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Ching C. Lau
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Kirsten Sundby Hall
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Hans Gelderblom
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Paul Meyers
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Richard Gorlick
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Reinhard Windhager
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Knut Helmke
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Mikael Eriksson
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Peter M. Hoogerbrugge
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Paula Schomberg
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Per-Ulf Tunn
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Thomas Kühne
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Heribert Jürgens
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Henk van den Berg
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Tom Böhling
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Susan Picton
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Marleen Renard
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Peter Reichardt
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Joachim Gerss
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Trude Butterfass-Bahloul
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Carol Morris
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Pancras C.W. Hogendoorn
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Beatrice Seddon
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Gabriele Calaminus
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Maria Michelagnoli
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Catharina Dhooge
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Matthew R. Sydes
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
| | - Mark Bernstein
- Stefan S. Bielack, Klinikum Stuttgart–Olgahospital, Stuttgart; Mathias Werner, Helios Klinikum Emil von Behring; Per-Ulf Tunn, Helios Klinikum Berlin-Buch, Berlin; Knut Helmke, Altonaer Kinderkrankenhaus, Hamburg; Heribert Jürgens, Gabriele Calaminus, Joachim Gerss, and Trude Butterfass-Bahloul, Universitätsklinikum Münster, Münster; Peter Reichardt, Klinik für Interdisziplinäre Onkologie, Bad Saarow, Germany; Sigbjørn Smeland and Kirsten Sundby Hall, Oslo University Hospital; Kirsten Sundby Hall, Norwegian Radium Hospital, Oslo, Norway; Jeremy S. Whelan, University College London Hospitals; Gordana Jovic, Jane M. Hook, and Matthew R. Sydes, University College London; Beatrice Seddon and Maria Michelagnoli, University College Hospital, London; Bernadette Brennan, Christie Hospital and Royal Manchester Children's Hospital, Manchester; Susan Picton, Leeds University Hospital, Leeds, United Kingdom; Neyssa Marina, Stanford University Medical Center; Claudia Deffenbaugh, Lucille Salter Packard Children's Hospital, Palo Alto; Mark D. Krailo, Children's Oncology Group, Arcadia, CA; Mark Gebhardt and Allen Goorin, Dana-Farber Cancer Institute; Mark Gebhardt and Lisa A. Teot, Children's Hospital Boston, Boston, MA; Zsuzsanna Pápai, National Medical Center, Budapest, Hungary; James Meyer, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA; Helen Nadel, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia; Mark Bernstein, Dalhousie University, Halifax, Nova Scotia, Canada; R. Lor Randall, University of Utah, Salt Lake City, UT; Rajaram Nagarajan, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; G. Douglas Letson, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL; Daniel Baumhoer, Universitätsspital Basel; Thomas Kühne, University Children's Hospital Basel, Basel, Switzerland; Leo Kager, St Anna's Children Hospital; Reinhard Windhager, Medical University of Vienna, Vienna, Austria; Ching C. Lau, Baylor College of Medicine, Houston, TX; Hans Gelderblom and Pancras C.W. Hogendoorn, Leiden University Medical Center, Leiden; Peter M. Hoogerbrugge, Radbound University Nijmegen Medical Centre, Nijmegen; Henk van den Berg, Emma Children's Hospital–Academic Medical Centre, Amsterdam, the Netherlands; Paul Meyers and Carol Morris, Memorial Sloan Kettering Cancer Center, New York; Richard Gorlick, Montefiore Medical Center, Bronx, NY; Mikael Eriksson, Skane University Hospital, Lund, Sweden; Paula Schomberg, Mayo Clinic, Rochester, MN; Tom Böhling, University of Helsinki and Hospital District of Helsinki and Uusimaa Laboratoriot, Helsinki, Finland; Marleen Renard, University Hospital Leuven, Leuven; and Catharina Dhooge, University Hospital Ghent, Ghent, Belgium
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Cockle JV, Picton S, Levesley J, Ilett E, Carcaboso AM, Short S, Steel LP, Melcher A, Lawler SE, Brüning-Richardson A. Cell migration in paediatric glioma; characterisation and potential therapeutic targeting. Br J Cancer 2015; 112:693-703. [PMID: 25628092 PMCID: PMC4333505 DOI: 10.1038/bjc.2015.16] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/12/2014] [Accepted: 12/17/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Paediatric high grade glioma (pHGG) and diffuse intrinsic pontine glioma (DIPG) are highly aggressive brain tumours. Their invasive phenotype contributes to their limited therapeutic response, and novel treatments that block brain tumour invasion are needed. METHODS Here, we examine the migratory characteristics and treatment effect of small molecule glycogen synthase kinase-3 inhibitors, lithium chloride (LiCl) and the indirubin derivative 6-bromoindirubin-oxime (BIO), previously shown to inhibit the migration of adult glioma cells, on two pHGG cell lines (SF188 and KNS42) and one patient-derived DIPG line (HSJD-DIPG-007) using 2D (transwell membrane, immunofluorescence, live cell imaging) and 3D (migration on nanofibre plates and spheroid invasion in collagen) assays. RESULTS All lines were migratory, but there were differences in morphology and migration rates. Both LiCl and BIO reduced migration and instigated cytoskeletal rearrangement of stress fibres and focal adhesions when viewed by immunofluorescence. In the presence of drugs, loss of polarity and differences in cellular movement were observed by live cell imaging. CONCLUSIONS Ours is the first study to demonstrate that it is possible to pharmacologically target migration of paediatric glioma in vitro using LiCl and BIO, and we conclude that these agents and their derivatives warrant further preclinical investigation as potential anti-migratory therapeutics for these devastating tumours.
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Affiliation(s)
- J V Cockle
- 1] Leeds Institute of Cancer Studies and Pathology, University of Leeds, Wellcome Trust Brenner Building, St James's University Hospital, Leeds, LS9 7TF, UK [2] Yorkshire Regional Centre for Paediatric Oncology and Haematology, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK
| | - S Picton
- Yorkshire Regional Centre for Paediatric Oncology and Haematology, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK
| | - J Levesley
- Leeds Institute of Cancer Studies and Pathology, University of Leeds, Wellcome Trust Brenner Building, St James's University Hospital, Leeds, LS9 7TF, UK
| | - E Ilett
- Leeds Institute of Cancer Studies and Pathology, University of Leeds, Wellcome Trust Brenner Building, St James's University Hospital, Leeds, LS9 7TF, UK
| | - A M Carcaboso
- Preclinical Therapeutics and Drug Delivery Research Program, Department of Oncology, Hospital Sant Joan de Déu Barcelona, Preclinical Therapeutics and Drug Delivery Research Program Santa Rosa, 39-57, 4th floor 08950 Esplugues de Llobregat, Barcelona, Spain
| | - S Short
- Leeds Institute of Cancer Studies and Pathology, University of Leeds, Wellcome Trust Brenner Building, St James's University Hospital, Leeds, LS9 7TF, UK
| | - L P Steel
- Leeds Institute of Cancer Studies and Pathology, University of Leeds, Wellcome Trust Brenner Building, St James's University Hospital, Leeds, LS9 7TF, UK
| | - A Melcher
- Leeds Institute of Cancer Studies and Pathology, University of Leeds, Wellcome Trust Brenner Building, St James's University Hospital, Leeds, LS9 7TF, UK
| | - S E Lawler
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 4 Blackfan Circle, HIM 930A, Boston, MA, 02115, USA
| | - A Brüning-Richardson
- Leeds Institute of Cancer Studies and Pathology, University of Leeds, Wellcome Trust Brenner Building, St James's University Hospital, Leeds, LS9 7TF, UK
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Vivekanandan S, Breene R, Ramanujachar R, Traunecker H, Pizer B, Gaze M, Saran F, Thorpe N, Picton S, English M, Wheeler K, Michalski A, Walker DA, Saunders D, Cowie F, Cameron A, Lee V, Parashar DH. P16 * METASTATIC MEDULLOBLASTOMA - UK RESULTS WITH INDUCTION AND HIGH DOSE CHEMOTHERAPY WITH HYPERFRACTIONATED ACCELERATED RADIOTHERAPY (THE MILAN STRATEGY). Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou249.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Drimtzias E, Falzon K, Picton S, Jeeva I, Guy D, Nelson O, Simmons I. The ophthalmic natural history of paediatric craniopharyngioma: a long-term review. J Neurooncol 2014; 120:651-6. [DOI: 10.1007/s11060-014-1600-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 08/23/2014] [Indexed: 11/30/2022]
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Geller T, Prakash V, Batanian J, Guzman M, Duncavage E, Gershon T, Crowther A, Wu J, Liu H, Fang F, Davis I, Tripolitsioti D, Ma M, Kumar K, Grahlert J, Egli K, Fiaschetti G, Shalaby T, Grotzer M, Baumgartner M, Braoudaki M, Lambrou GI, Giannikou K, Millionis V, Papadodima SA, Settas N, Sfakianos G, Stefanaki K, Kattamis A, Spiliopoulou CA, Tzortzatou-Stathopoulou F, Kanavakis E, Gholamin S, Mitra S, Feroze A, Zhang M, Esparza R, Kahn S, Richard C, Achrol A, Volkmer A, Liu J, Volkmer J, Majeti R, Weissman I, Cheshier S, Bhatia K, Brown N, Teague J, Lo P, Challis J, Beshay V, Sullivan M, Mechinaud F, Hansford J, Arifin MZ, Dahlan RH, Sobana M, Saputra P, Tisell MT, Danielsson A, Caren H, Bhardwaj R, Chakravadhanula M, Hampton C, Ozals V, Georges J, Decker W, Kodibagkar V, Nguyen A, Legrain M, Gaub MP, Pencreach E, Chenard MP, Guenot D, Entz-Werle N, Kanemura Y, Ichimura K, Shofuda T, Nishikawa R, Yamasaki M, Shibui S, Arai H, Xia J, Brian A, Prins R, Pennell C, Moertel C, Olin M, Bie L, Zhang X, Liu H, Olsson M, Kling T, Nelander S, Biassoni V, Bongarzone I, Verderio P, Massimino M, Magni R, Pizzamiglio S, Ciniselli C, Taverna E, De Bortoli M, Luchini A, Liotta L, Barzano E, Spreafico F, Visse E, Sanden E, Darabi A, Siesjo P, Jackson S, Cohen K, Lin D, Burger P, Rodriguez F, Yao X, Liucheng R, Qin L, Na T, Meilin W, Zhengdong Z, Yongjun F, Pfeifer S, Nister M, de Stahl TD, Basmaci E, Orphanidou-Vlachou E, Brundler MA, Sun Y, Davies N, Wilson M, Pan X, Arvanitis T, Grundy R, Peet A, Eden C, Ju B, Phoenix T, Nimmervoll B, Tong Y, Ellison D, Lessman C, Taylor M, Gilbertson R, Folgiero V, del Bufalo F, Carai A, Cefalo MG, Citti A, Rutella S, Locatelli F, Mastronuzzi A, Maher O, Khatua S, Zaky W, Lourdusamy A, Meijer L, Layfield R, Grundy R, Jones DTW, Capper D, Sill M, Hovestadt V, Schweizer L, Lichter P, Zagzag D, Karajannis MA, Aldape KD, Korshunov A, von Deimling A, Pfister S, Chakrabarty A, Feltbower R, Sheridon E, Hassan H, Shires M, Picton S, Hatziagapiou K, Braoudaki M, Lambrou GI, Tsorteki F, Tzortzatou-Stathopoulou F, Bethanis K, Gemou-Engesaeth V, Chi SN, Bandopadhayay P, Janeway K, Pinches N, Malkin H, Kieran MW, Manley PE, Green A, Goumnerova L, Ramkissoon S, Harris MH, Ligon KL, Kahlert U, Suarez M, Maciaczyk J, Bar E, Eberhart C, Kenchappa R, Krishnan N, Forsyth P, McKenzie B, Pisklakova A, McFadden G, Kenchappa R, Forsyth P, Pan W, Rodriguez L, Glod J, Levy JM, Thompson J, Griesinger A, Amani V, Donson A, Birks D, Morgan M, Handler M, Foreman N, Thorburn A, Lulla RR, Laskowski J, Fangusaro J, DiPatri AJ, Alden T, Tomita T, Vanin EF, Goldman S, Soares MB, Remke M, Ramaswamy V, Wang X, Jorgensen F, Morrissy AS, Marra M, Packer R, Bouffet E, Pfister S, Jabado N, Taylor M, Cole B, Rudzinski E, Anderson M, Bloom K, Lee A, Leary S, Leprivier G, Remke M, Rotblat B, Agnihotri S, Kool M, Derry B, Pfister S, Taylor MD, Sorensen PH, Dobson T, Busschers E, Taylor H, Hatcher R, Fangusaro J, Lulla R, Goldman S, Rajaram V, Das C, Gopalakrishnan V. TUMOUR BIOLOGY. Neuro Oncol 2014; 16:i137-i145. [PMCID: PMC4046298 DOI: 10.1093/neuonc/nou082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
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Classen CF, William D, Linnebacher M, Farhod A, Kedr W, Elsabe B, Fadel S, Van Gool S, De Vleeschouwer S, Koks C, Garg A, Ehrhardt M, Riva M, De Vleeschouwer S, Agostinis P, Graf N, Van Gool S, Yao TW, Yoshida Y, Zhang J, Ozawa T, James D, Nicolaides T, Kebudi R, Cakir FB, Gorgun O, Agaoglu FY, Darendeliler E, Van Gool S, De Vleeschouwer S, Al-Kofide A, Al-Shail E, Khafaga Y, Al-Hindi H, Dababo M, Haq AU, Anas M, Barria MG, Siddiqui K, Hassounah M, Ayas M, van Zanten SV, Jansen M, van Vuurden D, Huisman M, Vugts D, Hoekstra O, van Dongen G, Kaspers G, Cockle J, Ilett E, Scott K, Bruning-Richardson A, Picton S, Short S, Melcher A, Benesch M, Warmuth-Metz M, von Bueren AO, Hoffmann M, Pietsch T, Kortmann RD, Eyrich M, Graf N, Rutkowski S, Fruhwald MC, Faber J, Kramm C, Porkholm M, Valanne L, Lonnqvist T, Holm S, Lannering B, Riikonen P, Wojcik D, Sehested A, Clausen N, Harila-Saari A, Schomerus E, Thorarinsdottir HK, Lahteenmaki P, Arola M, Thomassen H, Saarinen-Pihkala UM, Kivivuori SM, Buczkowicz P, Hoeman C, Rakopoulos P, Pajovic S, Morrison A, Bouffet E, Bartels U, Becher O, Hawkins C, Gould TWA, Rahman CV, Smith SJ, Barrett DA, Shakesheff KM, Grundy RG, Rahman R, Barua N, Cronin D, Gill S, Lowisl S, Hochart A, Maurage CA, Rocourt N, Vinchon M, Kerdraon O, Escande F, Grill J, Pick VK, Leblond P, Burzynski G, Janicki T, Burzynski S, Marszalek A, Ramani N, Zaky W, Kannan G, Morani A, Sandberg D, Ketonen L, Maher O, Corrales-Medina F, Meador H, Khatua S, Brassesco M, Delsin L, Roberto G, Silva C, Ana L, Rego E, Scrideli C, Umezawa K, Tone L, Kim SJ, Kim CY, Kim IA, Han JH, Choi BS, Ahn HS, Choi HS, Haque F, Rahman R, Layfield R, Grundy R, Gandola L, Pecori E, Biassoni V, Schiavello E, Chiruzzi C, Spreafico F, Modena P, Bach F, Pignoli E, Massimino M, Drogosiewicz M, Dembowska-Baginska B, Jurkiewicz E, Filipek I, Perek-Polnik M, Swieszkowska E, Perek D, Bender S, Jones DT, Warnatz HJ, Hutter B, Zichner T, Gronych J, Korshunov A, Eils R, Korbel JO, Yaspo ML, Lichter P, Pfister SM, Yadavilli S, Becher OJ, Kambhampati M, Packer RJ, Nazarian J, Lechon FC, Fowkes L, Khabra K, Martin-Retortillo LM, Marshall LV, Vaidya S, Koh DM, Leach MO, Pearson AD, Zacharoulis S, Lechon FC, Fowkes L, Khabra K, Martin-Retortillo LM, Marshall LV, Schrey D, Barone G, Vaidya S, Koh DM, Pearson AD, Zacharoulis S, Panditharatna E, Stampar M, Siu A, Gordish-Dressman H, Devaney J, Kambhampati M, Hwang EI, Packer RJ, Nazarian J, Chung AH, Mittapalli RK, Elmquist WF, Becher OJ, Castel D, Debily MA, Philippe C, Truffaux N, Taylor K, Calmon R, Boddaert N, Le Dret L, Saulnier P, Lacroix L, Mackay A, Jones C, Puget S, Sainte-Rose C, Blauwblomme T, Varlet P, Grill J, Entz-Werle N, Maugard C, Bougeard G, Nguyen A, Chenard MP, Schneider A, Gaub MP, Tsoli M, Vanniasinghe A, Luk P, Dilda P, Haber M, Hogg P, Ziegler D, Simon S, Tsoli M, Vanniasinghe A, Monje M, Gurova K, Gudkov A, Haber M, Ziegler D, Zapotocky M, Churackova M, Malinova B, Zamecnik J, Kyncl M, Tichy M, Puchmajerova A, Stary J, Sumerauer D, Boult J, Vinci M, Taylor K, Perryman L, Box G, Jury A, Popov S, Ingram W, Monje M, Eccles S, Jones C, Robinson S, Emir S, Demir HA, Bayram C, Cetindag F, Kabacam GB, Fettah A, Boult J, Li J, Vinci M, Jury A, Popov S, Jamin Y, Cummings C, Eccles S, Bamber J, Sinkus R, Jones C, Robinson S, Nandhabalan M, Bjerke L, Vinci M, Burford A, Ingram W, Mackay A, von Bueren A, Baudis M, Clarke P, Collins I, Workman P, Jones C, Taylor K, Mackay A, Vinci M, Popov S, Ingram W, Entz-Werle N, Monje M, Olaciregui N, Mora J, Carcaboso A, Bullock A, Jones C, Vinci M, Mackay A, Burford A, Taylor K, Popov S, Ingram W, Monje M, Alonso M, Olaciregui N, de Torres C, Cruz O, Mora J, Carcaboso A, Jones C, Filipek I, Drogosiewicz M, Perek-Polnik M, Swieszkowska E, Dembowska-Baginska B, Jurkiewicz E, Perek D, Nguyen A, Pencreach E, Mackay A, Moussalieh FM, Guenot D, Namer I, Chenard MP, Jones C, Entz-Werle N, Pollack I, Jakacki R, Butterfield L, Hamilton R, Panigrahy A, Potter D, Connelly A, Dibridge S, Whiteside T, Okada H, Ahsan S, Raabe E, Haffner M, Warren K, Quezado M, Ballester L, Nazarian J, Eberhart C, Rodriguez F, Ramachandran C, Nair S, Quirrin KW, Khatib Z, Escalon E, Melnick S, Classen CF, Hofmann M, Schmid I, Simon T, Maass E, Russo A, Fleischhack G, Becker M, Hauch H, Sander A, Kramm C, Grasso C, Truffaux N, Berlow N, Liu L, Debily MA, Davis L, Huang E, Woo P, Tang Y, Ponnuswami A, Chen S, Huang Y, Hutt-Cabezas M, Warren K, Dret L, Meltzer P, Mao H, Quezado M, van Vuurden D, Abraham J, Fouladi M, Svalina MN, Wang N, Hawkins C, Raabe E, Hulleman E, Li XN, Keller C, Spellman PT, Pal R, Grill J, Monje M, Jansen MHA, Sewing ACP, Lagerweij T, Vuchts DJ, van Vuurden DG, Caretti V, Wesseling P, Kaspers GJL, Hulleman E, Cohen K, Raabe E, Pearl M, Kogiso M, Zhang L, Qi L, Lindsay H, Lin F, Berg S, Li XN, Muscal J, Amayiri N, Tabori U, Campbel B, Bakry D, Aronson M, Durno C, Gallinger S, Malkin D, Qaddumi I, Musharbash A, Swaidan M, Bouffet E, Hawkins C, Al-Hussaini M, Rakopoulos P, Shandilya S, McCully C, Murphy R, Akshintala S, Cole D, Macallister RP, Cruz R, Widemann B, Warren K, Salloum R, Smith A, Glaunert M, Ramkissoon A, Peterson S, Baker S, Chow L, Sandgren J, Pfeifer S, Popova S, Alafuzoff I, de Stahl TD, Pietschmann S, Kerber MJ, Zwiener I, Henke G, Kortmann RD, Muller K, von Bueren A, Sieow NYF, Hoe RHM, Tan AM, Chan MY, Soh SY, Hawkins C, Burrell K, Chornenkyy Y, Remke M, Golbourn B, Buczkowicz P, Barzczyk M, Taylor M, Rutka J, Dirks P, Zadeh G, Agnihotri S, Hashizume R, Ihara Y, Andor N, Chen X, Lerner R, Huang X, Tom M, Solomon D, Mueller S, Petritsch C, Zhang Z, Gupta N, Waldman T, James D, Dujua A, Co J, Hernandez F, Doromal D, Hegde M, Wakefield A, Brawley V, Grada Z, Byrd T, Chow K, Krebs S, Heslop H, Gottschalk S, Yvon E, Ahmed N, Truffaux N, Philippe C, Cornilleau G, Paulsson J, Andreiuolo F, Guerrini-Rousseau L, Puget S, Geoerger B, Vassal G, Ostman A, Grill J, Parsons DW, Lin F, Trevino LR, Gao F, Shen X, Hampton O, Lindsay H, Kosigo M, Qi L, Baxter PA, Su JM, Chintagumpala M, Dauser R, Adesina A, Plon SE, Li XN, Wheeler DA, Lau CC, Pietsch T, Gielen G, Muehlen AZ, Kwiecien R, Wolff J, Kramm C, Lulla RR, Laskowski J, Goldman S, Gopalakrishnan V, Fangusaro J, Mackay A, Taylor K, Vinci M, Jones C, Kieran M, Fontebasso A, Papillon-Cavanagh S, Schwartzentruber J, Nikbakht H, Gerges N, Fiset PO, Bechet D, Faury D, De Jay N, Ramkissoon L, Corcoran A, Jones D, Sturm D, Johann P, Tomita T, Goldman S, Nagib M, Bendel A, Goumnerova L, Bowers DC, Leonard JR, Rubin JB, Alden T, DiPatri A, Browd S, Leary S, Jallo G, Cohen K, Prados MD, Banerjee A, Carret AS, Ellezam B, Crevier L, Klekner A, Bognar L, Hauser P, Garami M, Myseros J, Dong Z, Siegel PM, Gump W, Ayyanar K, Ragheb J, Khatib Z, Krieger M, Kiehna E, Robison N, Harter D, Gardner S, Handler M, Foreman N, Brahma B, MacDonald T, Malkin H, Chi S, Manley P, Bandopadhayay P, Greenspan L, Ligon A, Albrecht S, Pfister SM, Ligon KL, Majewski J, Gupta N, Jabado N, Hoeman C, Cordero F, Halvorson K, Hawkins C, Becher O, Taylor I, Hutt M, Weingart M, Price A, Nazarian J, Eberhart C, Raabe E, Kantar M, Onen S, Kamer S, Turhan T, Kitis O, Ertan Y, Cetingul N, Anacak Y, Akalin T, Ersahin Y, Mason G, Nazarian J, Ho C, Devaney J, Stampar M, Kambhampati M, Crozier F, Vezina G, Packer R, Hwang E, Gilheeney S, Millard N, DeBraganca K, Khakoo Y, Kramer K, Wolden S, Donzelli M, Fischer C, Petriccione M, Dunkel I, Afzal S, Carret AS, Fleming A, Larouche V, Zelcer S, Johnston DL, Kostova M, Mpofu C, Decarie JC, Strother D, Lafay-Cousin L, Eisenstat D, Fryer C, Hukin J, Bartels U, Bouffet E, Hsu M, Lasky J, Moore T, Liau L, Davidson T, Prins R, Fouladi M, Bartels U, Warren K, Hassal T, Baugh J, Kirkendall J, Doughman R, Leach J, Jones B, Miles L, Hawkins C, Bouffet E, Hargrave D, Grill J, Jones C, Jacques T, Savage S, Goldman S, Leary S, Packer R, Saunders D, Wesseling P, Varlet P, van Vuurden D, Wallace R, Flutter B, Morgenestern D, Hargrave D, Blanco E, Howe K, Lowdell M, Samuel E, Michalski A, Anderson J, Arakawa Y, Umeda K, Watanabe KI, Mizowaki T, Hiraoka M, Hiramatsu H, Adachi S, Kunieda T, Takagi Y, Miyamoto S, Venneti S, Santi M, Felicella MM, Sullivan LM, Dolgalev I, Martinez D, Perry A, Lewis PW, Allis DC, Thompson CB, Judkins AR. HIGH GRADE GLIOMAS AND DIPG. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mathew RK, O'Kane R, Parslow R, Stiller C, Kenny T, Picton S, Chumas PD. Comparison of survival between the UK and US after surgery for most common pediatric CNS tumors. Neuro Oncol 2014; 16:1137-45. [PMID: 24799454 DOI: 10.1093/neuonc/nou056] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We report a population-based study examining long-term outcomes for common pediatric CNS tumors comparing results from the UK with the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) data set and with the literature. No such international study has previously been reported. METHODS Data between 1996 and 2005 from the UK National Registry of Childhood Tumours (NRCT) and the SEER registry were analyzed. We calculated actuarial survival at each time point from histological diagnosis, with death from any cause as the endpoint. Kaplan-Meier estimation and log-rank testing (Cox proportional hazards regression analysis) were used to calculate survival differences among tumor subtypes, adjusting for age at diagnosis. RESULTS Population-based outcomes for each tumor type are presented. Overall age-adjusted survival, stratifying for histology (combining pilocytic astrocytoma, anaplastic astrocytoma, glioblastoma, primitive neuroectodermal tumor, medulloblastoma, and ependymoma), is significantly lower for NRCT than SEER (hazard ratio 0.71, P < .001) and at 1, 5, and 10 years. Both NRCT and SEER outcomes are worse than those reported from trials. CONCLUSION Analyzing data from comprehensive registries minimizes bias associated with trials and institutional studies. The reasons for the poorer outcomes in children treated in the UK are unclear. Likewise, the differences in outcomes between patients in trials and those not in trials need further investigation. We recommend that all children with CNS tumors be recruited into studies-even if these are observational studies. We also suggest that registries be suitably funded to publish independent outcome data (including morbidity) at both a national and an institutional level.
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Affiliation(s)
- Ryan Koshy Mathew
- Department of Neurosurgery, General Infirmary at Leeds, Leeds, UK (R.K.M.); Department of Neurosurgery, Royal Hospital for Sick Children, Glasgow, UK (R.O.); Division of Epidemiology and Biostatistics, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK (R.P.); Childhood Cancer Research Group, Headington, Oxford, UK (C.S.); National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre, University of Southampton, Southampton, UK (T.K.); Department of Paediatric Oncology, General Infirmary at Leeds, Leeds, UK (S.P.); Department of Neurosurgery, General Infirmary at Leeds, Leeds, UK (P.D.C.)
| | - Roddy O'Kane
- Department of Neurosurgery, General Infirmary at Leeds, Leeds, UK (R.K.M.); Department of Neurosurgery, Royal Hospital for Sick Children, Glasgow, UK (R.O.); Division of Epidemiology and Biostatistics, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK (R.P.); Childhood Cancer Research Group, Headington, Oxford, UK (C.S.); National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre, University of Southampton, Southampton, UK (T.K.); Department of Paediatric Oncology, General Infirmary at Leeds, Leeds, UK (S.P.); Department of Neurosurgery, General Infirmary at Leeds, Leeds, UK (P.D.C.)
| | - Roger Parslow
- Department of Neurosurgery, General Infirmary at Leeds, Leeds, UK (R.K.M.); Department of Neurosurgery, Royal Hospital for Sick Children, Glasgow, UK (R.O.); Division of Epidemiology and Biostatistics, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK (R.P.); Childhood Cancer Research Group, Headington, Oxford, UK (C.S.); National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre, University of Southampton, Southampton, UK (T.K.); Department of Paediatric Oncology, General Infirmary at Leeds, Leeds, UK (S.P.); Department of Neurosurgery, General Infirmary at Leeds, Leeds, UK (P.D.C.)
| | - Charles Stiller
- Department of Neurosurgery, General Infirmary at Leeds, Leeds, UK (R.K.M.); Department of Neurosurgery, Royal Hospital for Sick Children, Glasgow, UK (R.O.); Division of Epidemiology and Biostatistics, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK (R.P.); Childhood Cancer Research Group, Headington, Oxford, UK (C.S.); National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre, University of Southampton, Southampton, UK (T.K.); Department of Paediatric Oncology, General Infirmary at Leeds, Leeds, UK (S.P.); Department of Neurosurgery, General Infirmary at Leeds, Leeds, UK (P.D.C.)
| | - Tom Kenny
- Department of Neurosurgery, General Infirmary at Leeds, Leeds, UK (R.K.M.); Department of Neurosurgery, Royal Hospital for Sick Children, Glasgow, UK (R.O.); Division of Epidemiology and Biostatistics, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK (R.P.); Childhood Cancer Research Group, Headington, Oxford, UK (C.S.); National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre, University of Southampton, Southampton, UK (T.K.); Department of Paediatric Oncology, General Infirmary at Leeds, Leeds, UK (S.P.); Department of Neurosurgery, General Infirmary at Leeds, Leeds, UK (P.D.C.)
| | - Susan Picton
- Department of Neurosurgery, General Infirmary at Leeds, Leeds, UK (R.K.M.); Department of Neurosurgery, Royal Hospital for Sick Children, Glasgow, UK (R.O.); Division of Epidemiology and Biostatistics, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK (R.P.); Childhood Cancer Research Group, Headington, Oxford, UK (C.S.); National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre, University of Southampton, Southampton, UK (T.K.); Department of Paediatric Oncology, General Infirmary at Leeds, Leeds, UK (S.P.); Department of Neurosurgery, General Infirmary at Leeds, Leeds, UK (P.D.C.)
| | - Paul Dominic Chumas
- Department of Neurosurgery, General Infirmary at Leeds, Leeds, UK (R.K.M.); Department of Neurosurgery, Royal Hospital for Sick Children, Glasgow, UK (R.O.); Division of Epidemiology and Biostatistics, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK (R.P.); Childhood Cancer Research Group, Headington, Oxford, UK (C.S.); National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre, University of Southampton, Southampton, UK (T.K.); Department of Paediatric Oncology, General Infirmary at Leeds, Leeds, UK (S.P.); Department of Neurosurgery, General Infirmary at Leeds, Leeds, UK (P.D.C.)
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Reed-Berendt R, Phillips B, Picton S, Chumas P, Warren D, Livingston JH, Hughes E, Morrall MCHJ. Cause and outcome of cerebellar mutism: evidence from a systematic review. Childs Nerv Syst 2014; 30:375-85. [PMID: 24452481 DOI: 10.1007/s00381-014-2356-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 01/02/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE Cerebellar mutism is a serious neurosurgical complication after posterior fossa surgery, but the cause, incidence and outcome remain incompletely defined. The aim of this paper was to identify and review all reports of this phenomenon to better delineate and improve the evidence base. METHODS A systematic search and retrieval of databases was conducted using advanced search techniques. Review/outcomes criteria were developed, and study quality was determined. RESULTS The retrieval identified 2,281 papers of which 96 were relevant, identifying 650 children with cerebellar mutism. Causative factors, clinical features and outcomes were reported variably; papers focussed on multiple areas, the majority reporting incidence in single or series of case studies with little or no analysis further than description. CONCLUSIONS The complexity and variability of data reporting, likely contributing factors and outcomes make cerebellar mutism difficult to predict in incidence and the degree of impact that may ensue. A clear and accepted universal definition would help improve reporting, as would the application of agreed outcome measures. Clear and consistent reporting of surgical technique remains absent. Recommendations for practice are provided.
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Affiliation(s)
- Rosa Reed-Berendt
- Paediatric Neuropsychology, The Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK
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Bailey S, Howman A, Wheatley K, Wherton D, Boota N, Pizer B, Fisher D, Kearns P, Picton S, Saran F, Gibson M, Glaser A, Connolly D, Hargrave D. Diffuse intrinsic pontine glioma treated with prolonged temozolomide and radiotherapy--results of a United Kingdom phase II trial (CNS 2007 04). Eur J Cancer 2013; 49:3856-62. [PMID: 24011536 PMCID: PMC3853623 DOI: 10.1016/j.ejca.2013.08.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 06/30/2013] [Accepted: 08/08/2013] [Indexed: 12/03/2022]
Abstract
Diffuse intrinsic pontine glioma (DIPG) has a dismal prognosis with no chemotherapy regimen so far resulting in any significant improvement over standard radiotherapy. In this trial, a prolonged regimen (21/28d) of temozolomide was studied with the aim of overcoming O(6)-methylguanine methyltransferase (MGMT) mediated resistance. Forty-three patients with a defined clinico-radiological diagnosis of DIPG received radiotherapy and concomitant temozolomide (75 mg/m(2)) after which up to 12 courses of 21d of adjuvant temozolomide (75-100mg/m(2)) were given 4 weekly. The trial used a 2-stage design and passed interim analysis. At diagnosis median age was 8 years (2-20 years), 81% had cranial nerve abnormalities, 76% ataxia and 57% long tract signs. Median Karnofsky/Lansky score was 80 (10-100). Patients received a median of three courses of adjuvant temozolomide, five received all 12 courses and seven did not start adjuvant treatment. Three patients were withdrawn from study treatment due to haematological toxicity and 10 had a dose reduction. No other significant toxicity related to temozolomide was noted. Overall survival (OS) (95% confidence interval (CI)) was 56% (40%, 69%) at 9 months, 35% (21%, 49%) at 1 year and 17% (7%, 30%) at 2 years. Median survival was 9.5 months (range 7.5-11.4 months). There were five 2-year survivors with a median age of 13.6 years at diagnosis. This trial demonstrated no survival benefit of the addition of dose dense temozolomide, to standard radiotherapy in children with classical DIPG. However, a subgroup of adolescent DIPG patients did have a prolonged survival, which needs further exploration.
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Affiliation(s)
- S. Bailey
- Great North Childrens Hospital, Newcastle upon Tyne, United Kingdom
| | - A. Howman
- CRCTU, University of Birmingham, Birmingham, United Kingdom
| | - K. Wheatley
- CRCTU, University of Birmingham, Birmingham, United Kingdom
| | - D. Wherton
- CRCTU, University of Birmingham, Birmingham, United Kingdom
| | - N. Boota
- Nottingham Clinical Trials Unit, Nottingham, United Kingdom
| | - B. Pizer
- Alder Hey Childrens Hospital, Liverpool, United Kingdom
| | - D. Fisher
- Addenbroookes Hopsital, Cambridge, United Kingdom
| | - P. Kearns
- CRCTU, University of Birmingham, Birmingham, United Kingdom
| | - S. Picton
- Leeds General Infirmary, Leeds, United Kingdom
| | - F. Saran
- Royal Marsden Hospital, Surrey, London, United Kingdom
| | - M. Gibson
- CRCTU, University of Birmingham, Birmingham, United Kingdom
| | - A. Glaser
- Leeds General Infirmary, Leeds, United Kingdom
| | | | - D. Hargrave
- Great Ormond Street Hospital For Sick Children, London, United Kingdom
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Caretti V, Noll A, Woo P, Monje M, Cockle J, Bruning-Richardson A, Picton S, Levesley J, Ilett E, Short S, Melcher A, Lawler S, Garzia L, Dubuc A, Pitcher G, Northcott P, Mariampillai A, Mack S, Zayne K, Chan T, Skowron P, Wu X, Lionel A, Morrisy S, Hawkins C, Kongkham P, Rutka J, Huang A, Kenney A, Yang V, Salter M, Taylor M, Garzia L, Morrisy S, Skowron P, Jelveh S, Lindsay P, Largaespada D, Collier L, Dupuy A, Hill R, Taylor M, Hsieh TH, Wang HW, Cheng WC, Wong TT, Huang X, He Y, Dubuc A, Hashizume R, Zhang W, Stehbens S, Younger S, Barshow S, Zhu S, Wu X, Taylor M, Mueller S, Weiss W, James D, Shuman M, Jan YN, Jan L, Marigil M, Jauregi P, Idoate MA, Xipell E, Aldave G, Gonzalez-Huarriz M, Tejada-Solis S, Diez-Valle R, Montero-Carcaboso A, Mora J, Alonso MM, Taylor K, Mackay A, Truffaux N, Morozova O, Butterfield Y, Phillipe C, Vinci M, de Torres C, Cruz O, Mora J, Hargrave D, Monje M, Puget S, Yip S, Jones C, Grill J, Kaul A, Chen YH, Dahiya S, Emnett R, Gianino S, Gutmann D, Miwa T, Oi S, Nonaka Y, Sasaki H, Yoshida K, Lopez E, de Leon AP, Sepulveda C, Zarate L, Diego-Perez J, Pong W, Ding L, McLellan M, Hussain I, Emnett R, Gianino S, Higer S, Leonard J, Guha A, Mardis E, Gutmann D, Sarkar C, Pathak P, Jha P, Purkait S, Sharma V, Sharma MC, Suri V, Faruq M, Mukherjee M, Sivasankaran B, Velayutham RP, Fraschilla IR, Morris KJ, MacDonald TJ, Read TA, Sturm D, Northcott P, Jones D, Korshunov A, Picard D, Lichter P, Huang A, Pfister S, Kool M, Yao TW, Zhang J, Anna B, Brummer T, Gupta N, Nicolaides T, Chan KM, Fang D, Gan H, Hashizume R, Yu C, Schroeder M, Gupta N, Mueller S, James D, Jenkins R, Sarkaria J, Zhang Z. PEDIATRICS LABORATORY RESEARCH. Neuro Oncol 2013. [DOI: 10.1093/neuonc/not186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
PURPOSE It is often assumed that prolonged time to diagnosis (TTD) for cancer negatively influences overall survival and survivorship through advanced stage disease at diagnosis. This systematic review assesses existing early diagnosis research in childhood and young adult cancer and aims to identify whether a consensus exists within the literature in relation to the terminology and methodologies used to investigate TTD in this population. METHODS Medline, Embase, the Centre for Reviews and Dissemination database and Cochrane library were searched for papers on children and young adults (0-30 years) published from 1948 to the present. RESULTS Of the 1665 potentially eligible citations identified, 32 papers met the inclusion criteria. The majority of work was in European (n=15) or North American (n=8) populations. Most work focused on brain tumours (n=10), retinoblastomas (n=5) and bone and soft tissue sarcomas (n=4). The majority of studies were in hospital-based settings (n=25), with only seven papers adopting a population-based setting. Summary statistics presented were mostly median TTD, the skewed distribution of the data meant comparisons between studies based on medians were difficult and combining studies within a meta-analysis was not appropriate. CONCLUSIONS Within the childhood and young adult population, TTD for cancer varies between diagnostic groups and with age at diagnosis in the majority of studies. In order that clear conclusions can be drawn from early diagnosis research in children and young adults, specific criteria identifying circumstances in which delay has occurred should accompany a defined time line to diagnosis or treatment in every study.
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Affiliation(s)
- Christopher David Lethaby
- Yorkshire Regional Centre for Paediatric Oncology and Haematology, Leeds General Infirmary, Leeds, Yorkshire, UK.
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Walker DA, Liu J, Kieran M, Jabado N, Picton S, Packer R, St Rose C. A multi-disciplinary consensus statement concerning surgical approaches to low-grade, high-grade astrocytomas and diffuse intrinsic pontine gliomas in childhood (CPN Paris 2011) using the Delphi method. Neuro Oncol 2013; 15:462-8. [PMID: 23502427 DOI: 10.1093/neuonc/nos330] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Astrocytic tumors account for 42% of childhood brain tumors, arising in all anatomical regions and associated with neurofibromatosis type 1 (NF1) in 15%. Anatomical site determines the degree and risk of resectability; the more complete resection, the better the survival rates. New biological markers and modern radiotherapy techniques are altering the risk assessments of clinical decisions for tumor resection and biopsy. The increasingly distinct pediatric neuro-oncology multidisciplinary team (PNMDT) is developing a distinct evidence base. A multidisciplinary consensus conference on pediatric neurosurgery was held in February 2011, where 92 invited participants reviewed evidence for clinical management of hypothalamic chiasmatic glioma (HCLGG), diffuse intrinsic pontine glioma (DIPG), and high-grade glioma (HGG). Twenty-seven statements were drafted and subjected to online Delphi consensus voting by participants, seeking >70% agreement from >60% of respondents; where <70% consensus occurred, the statement was modified and resubmitted for voting. Twenty-seven statements meeting consensus criteria are reported. For HCLGG, statements describing overall therapeutic purpose and indications for biopsy, observation, or treatment aimed at limiting the risk of visual damage and the need for on-going clinical trials were made. Primary surgical resection was not recommended. For DIPG, biopsy was recommended to ascertain biological characteristics to enhance understanding and targeting of treatments, especially in clinical trials. For HGG, biopsy is essential, the World Health Organization classification was recommended; selection of surgical strategy to achieve gross total resection in a single or multistep process should be discussed with the PNMDT and integrated with trials based drug strategies for adjuvant therapies.
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Affiliation(s)
- David A Walker
- Children's Brain Tumour Research Centre, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK.
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Zaghloul M, Ahmed S, Eldebaway E, Mousa A, Amin A, Elkhateeb N, Sabry M, Ogiwara H, Morota N, Sufit A, Donson A, Birks D, Patel P, Foreman N, Handler M, Massimino M, Biassoni V, Gandola L, Schiavello E, Pecori E, Potepan P, Bach F, Janssens GO, Jansen MH, Lauwers SJ, Nowak PJ, Oldenburger FR, Bouffet E, Saran F, van Ulzen KK, van Lindert EJ, Schieving JH, Boterberg T, Kaspers GJ, Span PN, Kaanders JH, Gidding CE, Hargrave D, Bailey S, Howman A, Pizer B, Harris D, Jones D, Kearns P, Picton S, Saran F, Wheatley K, Gibson M, Glaser A, Connolly D, Hargrave D, Kawamura A, Nagashima T, Yamamoto K, Sakata J, Lober R, Freret M, Fisher P, Edwards M, Yeom K, Monje M, Jansen M, Aliaga ES, Van Der Hoeven E, Van Vuurden D, Heymans M, Gidding C, De Bont E, Reddingius R, Peeters-Scholte C, van Meeteren AS, Gooskens R, Granzen B, Paardekoper G, Janssens G, Noske D, Barkhof F, Vandertop WP, Kaspers G, Saratsis A, Yadavilli S, Nazarian J, Monje M, Freret M, Mitra S, Mallick S, Kim J, Beachy P, Nobre L, Vasconcelos F, Lima F, Mattos D, Kuiven N, Lima G, Silveira J, Sevilha M, Lima MA, Ferman S, Leblond P, Lansiaux A, Rialland X, Gentet JC, Geoerger B, Frappaz D, Aerts I, Bernier-Chastagner V, Shah R, Zaky W, Grimm J, Bluml S, Wong K, Dhall G, Caretti V, Schellen P, Lagerweij T, Bugiani M, Navis A, Wesseling P, Vandertop WP, Noske DP, Kaspers G, Wurdinger T, Lee H, Ziegler D, Schroeder K, Huang E, Berlow N, Patel R, Becher O, Taylor I, Mao XG, Hutt M, Weingart M, Kahlert U, Maciacyk J, Nikkhah G, Eberhart C, Raabe E, Barton K, Misuraca K, Misuraca K, Becher O, Zhou Z, Rotman L, Ho S, Souweidane M, Hutt M, Lim KJ, Warren K, Chang H, Eberhart C, Raabe E, Lightner D, Haque S, Souweidane M, Khakoo Y, Dunkel I, Gilheeney S, Kramer K, Lyden D, Wolden S, Greenfield J, De Braganca K, Ting-Rong H, Muh-Li L, Kai-Ping C, Tai-Tong W, Hsin-Hung C, Kebudi R, Cakir FB, Agaoglu FY, Gorgun O, Dizdar Y, Ayan I, Darendeliler E, Zapotocky M, Churackova M, Malinova B, Kodet R, Kyncl M, Tichy M, Stary J, Sumerauer D, Minturn J, Shu HK, Fisher M, Patti R, Janss A, Allen J, Phillips P, Belasco J, Taylor K, Baudis M, von Beuren A, Fouladi M, Jones C. DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG). Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Shih CS, Ekoma S, Ho C, Pradhan K, Hwang E, Jakacki R, Fisher M, Kilburn L, Horn M, Vezina G, Rood B, Packer R, Mittal R, Omar S, Khalifa N, Bedir R, Avery R, Hwang E, Acosta M, Hutcheson K, Santos D, Zand D, Kilburn L, Rosenbaum K, Rood B, Packer R, Kalin-Hajdu E, Ospina L, Carret AS, Marzouki M, Decarie JC, Freeman E, Hershon L, Warmuth-Metz M, Zurakowski D, Bison B, Falkenstein F, Gnekow A, Ehrstedt C, Laurencikas E, Bjorklund AC, Stromberg B, Hedborg F, Pfeifer S, Bertin D, Packer RJ, Vallero S, Basso ME, Romano E, Peretta P, Morra I, D'Alonzo G, Fagioli F, Toledano H, Laviv Y, Dratviman-Storobinsky O, Michowiz S, Yaniv I, Cohen IJ, Goldenberg-Cohen N, Muller K, Gnekow A, Warmuth-Metz M, Pietsch T, Zwiener I, Falkenstein F, Meyer FM, Micke O, Hoffmann W, Kortmann RD, Shofty B, Ben-Sira L, Roth J, Constantini S, Shofty B, Weizmann L, Joskowicz L, Kesler A, Ben-Bashat D, Yalon M, Dvir R, Freedman S, Roth J, Ben-Sira L, Constantini S, Bandopadhayay P, Dagi L, Robison N, Goumnerova L, Ullrich N, Opocher E, De Salvo GL, De Paoli A, Simmons I, Sehested A, Walker DA, Picton SV, Gnekow A, Grill J, Driever PH, Azizi AA, Viscardi E, Perilongo G, Cappellano AM, Bouffet E, Silva F, Paiva P, Cavalheiro S, Seixas MT, Silva NS, Antony R, Fraser K, Lin J, Falkenstein F, Kwiecien R, Mirow C, Thieme B, von Hornstein S, Pietsch T, Faldum A, Warmuth-Metz M, Kortmann RD, Gnekow AK, Shofty B, Bokshtein F, Kesler A, Ben-Sira L, Freedman S, Constantini S, Panandiker AP, Klimo P, Thompson C, Armstrong G, Kun L, Boop F, Sanford A, Orge F, Laschinger K, Gold D, Bangert B, Stearns D, Cappellano AM, Senerchia A, Paiva P, Cavalheiro S, Silva F, Silva NS, Gnekow AK, Falkenstein F, Walker D, Perilongo G, Picton S, Grill J, Kortmann RD, Stokland T, van Meeteren AS, Slavc I, Faldum A, de Salvo GL, Fernandez KS, Antony R, Lulla RR, Flores M, Benavides VC, Mitchell C, AlKofide A, Hassonah M, Khafagh Y, Ayas MA, AlFawaz I, Anas M, Barria M, Siddiqui K, Al-Shail E, Fisher MJ, Ullrich NJ, Ferner RE, Gutmann DH, Listernick R, Packer RJ, Tabori U, Hoffman RO, Ardern-Holmes SL, Hummel TR, Hargrave DR, Charrow J, Loguidice M, Balcer LJ, Liu GT, Fisher MJ, Listernick R, Gutmann DH, Ferner RE, Packer RJ, Ullrich NJ, Tabori U, Hoffman RO, Ardern-Holmes SL, Hummel TR, Hargrave DR, Loguidice M, Balcer LJ, Liu GT, Jeeva I, Nelson O, Guy D, Damani A, Gogi D, Picton S, Simmons I, Jeeva I, Picton S, Guy D, Nelson O, Dewsbery S, Gogi D, Simmons I, Sievert AJ, Lang SS, Boucher K, Slaunwhite E, Brewington D, Madsen P, Storm PB, Resnick AC, Hemenway M, Madden J, Macy M, Foreman N, Rush S, Mascelli S, Raso A, Barla A, Nozza P, Biassoni R, Pignatelli S, Cama A, Verri A, Capra V, Garre M, Bergthold G, Piette C, Raquin MA, Dufour C, Varlet P, Dhermain F, Puget S, Sainte-Rose C, Abely M, Canale S, Grill J, Terashima K, Chow K, Jones J, Ahern C, Jo E, Ellezam B, Paulino A, Okcu MF, Su J, Adesina A, Mahajan A, Dauser R, Whitehead W, Lau C, Chintagumpala M, Kebudi R, Tuncer S, Cakir FB, Gorgun O, Agaoglu FY, Ayan I, Darendeliler E, Wolf D, Cohen K, Jeyapalan JN, Morley ICF, Hill AA, Tatevossian RG, Qaddoumi I, Ellison DW, Sheer D, Donson A, Barton V, Birks D, Kleinschmidt-DeMasters BK, Hemenway M, Handler M, Foreman N, Rush S, Tatevossian R, Qaddoumi I, Tang B, Dalton J, Shurtleff S, Punchihewa C, Orisme W, Neale G, Gajjar A, Baker S, Sheer D, Ellison D, Gilheeney S, Jamzadeh A, Winchester M, Yataghene K, De Braganca K, Khakoo Y, Lyden D, Dunkel I, Terasaki M, Eto T, Morioka M, Ho CY, Bar E, Giannini C, Karajannis MA, Zagzag D, Eberhart CG, Rodriguez FJ, Lee Y, Bartels U, Tabori U, Huang A, Bouffet E, Zaky W, Bluml S, Grimm J, Wong K, McComb G, Gilles F, Finlay J, Dhall G, Chen HH, Chen YW, Chang FC, Lin SC, Chang KP, Ho DM, Wong TT, Lee CC, Azizi AA, Fox R, Grill J, Mirow C, Gnekow A, Walker D, Perilongo G, Opocher E, Wheatley K, van Meeteren AYS, Phuakpet K, Tabori U, Bartels U, Huang A, Kulkarni A, Laperriere N, Bouffet E, Epari S, Nair V, Gupta T, Patil P, Moiyadi A, Shetty P, Kane S, Jalali R, Dorris K, Nadi M, Sutton M, Wang L, Stogner K, Li D, Hurwitz B, Stevenson C, Miles L, Kim MO, Fuller C, Hawkins C, Bouffet E, Jones B, Drake J, Fouladi M, Fontebasso AM, Shirinian M, Jones DTW, Quang DAK, Jacob K, Cin H, Witt H, Gerges N, Montpetit A, Brunet S, Lepage P, Klekner A, Lambert S, Kwan T, Hawkins C, Tabori U, Collins VP, Albrecht S, Pfister SM, Jabado N, Arrington D, Manley P, Kieran M, Chi S, Robison N, Chordas C, Ullrich N. LOW GRADE GLIOMAS. Neuro Oncol 2012; 14:i69-i81. [PMCID: PMC3483338 DOI: 10.1093/neuonc/nos092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
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Rednam S, Scheurer M, Adesina A, Lau C, Okcu M, Deatrick J, Ogle S, Fisher M, Barakat L, Hardie T, Li Y, Ginsberg J, Ben-Arush M, Krivoy E, Rosenkranz R, Peretz-Nahum M, Brown RJ, Love J, Warburton D, McBride WH, Bluml S, Mueller S, Sear K, Hills N, Chettout N, Afghani S, Lew L, Tolentino E, Haas-Kogan D, Fullerton H, Reddick W, Palmer S, Glass J, Li Y, Ogg R, Gajjar A, Omar A, Perkins S, Shinohara E, Spoljaric D, Isenberg J, Whittington M, Hauff M, King A, Litzelman K, Barker E, Catrine K, Puccetti D, Possin P, Witt W, Mallucci C, Kumar R, Pizer B, Williams D, Pettorini B, Piscione J, Bouffet E, Shams I, Kulkarni A, Remes T, Harila-Saari A, Suo-Palosaari M, Arikoski P, Riikonen P, Sutela A, Koskenkorva P, Ojaniemi M, Rantala H, Campen CJ, Ashby D, Fisher PG, Monje M, Kulkarni AV, Piscione J, Shams I, Bouffet E, Nakamura H, Makino K, Yano S, Kuratsu JI, Jadrijevic-Cvrlje F, Batinica M, Toledano H, Hoffman T, Ezer-Cohen Y, Michowiz S, Yaniv I, Cohen IJ, Adler I, Mindel S, Gopalakrishnamoorthy M, Saunders D, Gaze M, Spoudeas H, Kieffer V, Dellatolas G, Chevignard M, Puget S, Dhermain F, Grill J, Dufour C, Muir R, Hunter A, Latchman A, de Camargo O, Scheinemann K, Dhir N, Zaky W, Zomorodian T, Wong K, Dhall G, Macy M, Lauro C, Zeitler P, Foreman N, Liu A, Chocholous M, Dodier P, Peyrl A, Dieckmann K, Hausler G, Slavc I, Avula S, Kumar R, Mallucci C, Pettorini B, Garlick D, Pizer B, Armstrong G, Kawashima T, Leisenring W, Stovall M, Sklar C, Robison L, Samaan C, Duckworth J, Scheinemann K, Greenberg-Kushnir N, Freedman S, Eshel R, Zverling N, Elhasid R, Dvir R, Yalon M, Kulkarni AV, Constantini S, Wilne S, Liu JF, Trusler J, Lundsell S, Kennedy C, Clough L, Dickson N, Lakhanpaul M, Baker M, Dudley J, Grundy R, Walker D, von Hoff K, Herzog N, Ottensmeier H, Grabow D, Gerber NU, Friedrich C, von Bueren AO, Resch A, Kortmann RD, Kaatsch P, Doerr HG, Rutkowski S, del Bufalo F, Mastronuzzi A, Serra A, de Sio L, Locatelli F, Biassoni V, Leonardi M, Ajovalasit D, Riva D, Vago C, Usilla A, Fidani P, Serra A, Schiavello E, Gariboldi F, Massimino M, Lober R, Perrault S, Partap S, Edwards M, Fisher P, Yeom K, Salgado D, Nunes S, Vinhais S, Salgado D, Nunes S, Vinhais S, Wells EM, Seidel K, Ullrich NJ, Leisenring W, Armstrong G, Diller L, King A, Krull KR, Neglia J, Robison LL, Stovall M, Whelan K, Sklar C, Russell CE, Bouffet E, Brownstone D, Kaise C, Kennedy C, Bull K, Culliford D, Chevignard M, Spoudeas H, Calaminus G, Bertin D, Vallero S, Romano E, Basso ME, Biasin E, Fagioli F, Ziara K, L'Hotta A, Williams A, Thede R, Moore K, James A, King A, Bjorn E, Franzen P, Haag A, Lax AK, Moreno I, Scheinemann K, Obeid J, Timmons BW, Iwata W, Wagner S, Lai JS, Waddell K, VanLeeuwen S, Newmark M, Noonan J, O'Connell K, Urban M, Yount S, Goldman S, Piscione J, Igoe D, Cunningham T, Orfus M, Bouffet E, Mabbott D, Liptak C, Manley P, Recklitis C, Zhang P, Shaikh F, Narang I, Bouffet E, Matsumoto K, Yamasaki K, Okada K, Fujisaki H, Osugi Y, Hara J, Phipps K, Gumley D, Jacques T, Hargrave D, Saunders D, Michalski A, Manley P, Chordas C, Chi S, Robison N, Bandopadhayay P, Marcus K, Zimmerman MA, Goumnerova L, Kieran M, Brand S, Brinkman T, Chordas C, Delaney B, Diver T, Rey C, Manley P, Liptak C, Madden JR, Hemenway MS, Dorneman L, Stiller D, Liu AK, Foreman NK, Vibhakar R, Mitchell M, Hemenway M, Foreman N, Madden J, Reddick W, Glass J, Li Y, Ogg R, Gajjar A, Ryan M, O'Kane R, Picton S, Kenny T, Stiller C, Chumas P, Bendel A, Patterson R, Barrera M, Schulte F, Bartels U, Janzen L, Johnston D, Cataudella D, Chung J, Sung L, Hancock K, Hukin J, Zelcer S, Brandon S, Montour-Proulx I, Strother D, Cooksey R, Bowers D, Gargan L, Gode A, Klesse L, Oden J, Vega G, Sala F, Nuzzi D, Mulino M, Masotto B, Mazza C, Bricolo A, Gerosa M, Tong M, Bouffet E, Laughlin S, Mackie S, Taylor L, Sharpe G, Al-Salihi O, Nicolin G. QUALITY OF LIFE/AFTERCARE. Neuro Oncol 2012; 14:i125-i139. [PMCID: PMC3483352 DOI: 10.1093/neuonc/nos106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
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Khatua S, Brown R, Pearlman M, Vats T, Satge D, Stiller C, Rutkowski S, von Bueren AO, Lacour B, Sommelet D, Nishi M, Massimino M, Garre ML, Moreno F, Hasle H, Jakab Z, Greenberg M, von der Weid N, Kuehni C, Zurriaga O, Vicente ML, Peris-Bonet R, Benesch M, Vekemans M, Sullivan S, Rickert C, Fisher PG, Von Behren J, Nelson DO, Reynolds P, Fukuoka K, Yanagisawa T, Suzuki T, Koga T, Wakiya K, Adachi JI, Mishima K, Fujimaki T, Matsutani M, Nishikawa R, Gidding C, Schieving J, Wesseling P, Ligtenberg M, Hoogerbrugge N, Jongmans M, Crosier S, Nicholson SL, Robson K, Jacques T, Wharton S, Bown N, Michalski A, Pizer B, Clifford S, Sanden E, Visse E, Siesjo P, Darabi A, Nousome D, Lupo PJ, Scheurer ME, Nulman I, Barrera M, Maxwell C, Koren G, Gorelyshev S, Matuev K, Lubnin A, Laskov M, Lemeneva N, Mazerkina N, Khuhlaeva E, Muller K, Bruns F, Pietsch T, Rutkowski S, Kortmann RD, Krishnatry R, Shirsat N, Kunder R, Epari S, Gupta T, Kurkure P, Vora T, Arora B, Moiyadi A, Jalali R, Swieszkowska E, Dembowska-Baginska B, Drogosiewicz M, Filipek I, Perek-Polnik M, Grajkowska W, Perek D, Johnston D, Cyr J, Strother D, Lafay-Cousin L, Fryer C, Scheinemann K, Carret AS, Fleming A, Larouche V, Bouffet E, Friedrich C, Gnekow AK, Fleischhack G, Kramm CM, Fruehwald MC, Muller HL, Calaminus G, Kordes U, Faldum A, Pietsch T, Warmuth-Metz M, Kortmann RD, Jung I, Kaatsch P, Rutkowski S, Caretti V, Bugiani M, Boor I, Schellen P, Vandertop WP, Noske DP, Kaspers G, Wurdinger T, Wesseling P, Robinson G, Chingtagumpala M, Adesina A, Dalton J, Santi M, Sievert A, Wright K, Armstrong G, Boue D, Olshefski R, Scott S, Huang A, Cohn R, Gururangan S, Bowers D, Gilbertson R, Gajjar A, Ellison D, Chick E, Donson A, Owens E, Smith AA, Madden JR, Foreman NK, Bakry D, Aronson M, Durno C, Hala R, Farah R, Amayiri N, Alharbi Q, Shamvil A, Ben-Shachar S, Constantini S, Rina D, Ellise J, Keiles S, Pollet A, Qaddoumi I, Gallinger S, Malkin D, Bouffet E, Hawkins C, Tabori U, Trivedi M, Goodden J, Chumas P, Tyagi A, O'kane R, Trivedi M, Goodden J, Chumas P, Tyagi A, O'Kane R, Crimmins D, Picton S, Elliott M. EPIDEMIOLOGY. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Li KKW, Pang JCS, Ng HK, Massimino M, Gandola L, Biassoni V, Spreafico F, Schiavello E, Poggi G, Casanova M, Pecori E, De Pava MV, Ferrari A, Meazza C, Terenziani M, Polastri D, Luksch R, Podda M, Modena P, Antonelli M, Giangaspero F, Ahmed S, Zaghloul MS, Mousa AG, Eldebawy E, Elbeltagy M, Awaad M, Massimino M, Gandola L, Biassoni V, Antonelli M, Schiavello E, Buttarelli F, Spreafico F, Collini P, Pollo B, Patriarca C, Giangaspero F, MacDonald T, Liu J, Munson J, Park J, Wang K, Fei B, Bellamkonda R, Arbiser J, Gomi A, Yamaguchi T, Mashiko T, Oguro K, Somasundaram A, Neuberg R, Grant G, Fuchs H, Driscoll T, Becher O, McLendon R, Cummings T, Gururangan S, Bourdeaut F, Grison C, Doz F, Pierron G, Delattre O, Couturier J, Cho YJ, Pugh T, Weeraratne SD, Archer T, Krummel DP, Auclair D, Cibulkis K, Lawrence M, Greulich H, McKenna A, Ramos A, Shefler E, Sivachenko A, Amani V, Pierre-Francois J, Teider N, Northcott P, Taylor M, Meyerson M, Pomeroy S, Potts C, Cline H, Rotenberry R, Guldal C, Bhatia B, Nahle Z, Kenney A, Fan YN, Pizer B, See V, Makino K, Nakamura H, Kuratsu JI, Grahlert J, Ma M, Fiaschetti G, Shalaby T, Grotzer M, Baumgartner M, Clifford S, Gustafsson G, Ellison D, Figarella-Branger D, Doz F, Rutkowski S, Lannering B, Pietsch T, Fiaschetti G, Shalaby T, Baumgartner M, Grotzer M, Fleischhack G, Siegler N, Zimmermann M, Rutkowski S, Warmuth-Metz M, Kortmann RD, Pietsch T, Faldum A, Bode U, Yoon JH, Kang HJ, Park KD, Park SH, Phi JH, Kim SK, Wang KC, Kim IH, Shin HY, Ahn HS, Faria C, Golbourn B, Smith C, Rutka J, Greene BD, Whitton A, Singh S, Scheinemann K, Hill R, Lindsey J, Howell C, Ryan S, Shiels K, Shrimpton E, Bailey S, Clifford S, Schwalbe E, Lindsey J, Williamson D, Hamilton D, Northcott P, O'Toole K, Nicholson SL, Lusher M, Gilbertson R, Hauser P, Taylor M, Taylor R, Ellison D, Bailey S, Clifford S, Kool M, Jones DTW, Jager N, Hovestadt V, Schuller U, Jabado N, Perry A, Cowdrey C, Croul S, Collins VP, Cho YJ, Pomeroy S, Eils R, Korshunov A, Lichter P, Pfister S, Northcott P, Shih D, Taylor M, Darabi A, Sanden E, Visse E, Siesjo P, Harris P, Venkataraman S, Alimova I, Birks D, Cristiano B, Donson A, Foreman N, Vibhakar R, Bertin D, Vallero S, Basso ME, Romano E, Peretta P, Morra I, Mussano A, Fagioli F, Kunkele A, De Preter K, Heukamp L, Thor T, Pajtler K, Hartmann W, Mittelbronn M, Grotzer M, Deubzer H, Speleman F, Schramm A, Eggert A, Schulte J, Bandopadhayay P, Kieran M, Manley P, Robison N, Chi S, Thor T, Mestdagh P, Vandesomple J, Fuchs H, Durner VG, de Angelis MH, Heukamp L, Kunkele A, Pajtler K, Eggert A, Schramm A, Schulte JH, Ohe N, Yano H, Nakayama N, Iwama T, Lastowska M, Perek-Polnik M, Grajkowska W, Malczyk K, Cukrowska B, Dembowska-Baginska B, Perek D, Othman RT, Storer L, Grundy R, Kerr I, Coyle B, Hulleman E, Lagerweij T, Biesmans D, Crommentuijn MHW, Cloos J, Tannous BA, Vandertop WP, Noske DP, Kaspers GJL, Wurdinger T, Bergthold G, El Kababri M, Varlet P, Dhermain F, Sainte-Rose C, Raquin MA, Valteau-Couanet D, Grill J, Dufour C, Burchill C, Hii H, Dallas P, Cole C, Endersby R, Gottardo N, Gevorgian A, Morozova E, Kazantsev I, Youhta T, Safonova S, Kozlov A, Punanov Y, Afanasyev B, Zheludkova O, Packer R, Gajjar A, Michalski J, Jakacki R, Gottardo N, Tarbell N, Vezina G, Olson J, Friedrich C, von Bueren AO, von Hoff K, Gerber NU, Benesch M, Faldum A, Pietsch T, Warmuth-Metz M, Kuehl J, Kortmann RD, Rutkowski S, Malbari F, Atlas M, Friedman G, Kelly V, Bray A, Cassady K, Markert J, Gillespie Y, Taylor R, Howman A, Brogden E, Robinson K, Jones D, Gibson M, Bujkiewicz S, Mitra D, Saran F, Michalski A, Pizer B, Jones DTW, Jager N, Kool M, Zichner T, Hutter B, Sultan M, Cho YJ, Pugh TJ, Warnatz HJ, Reifenberger G, Northcott PA, Taylor MD, Meyerson M, Pomeroy SL, Yaspo ML, Korbel JO, Korshunov A, Eils R, Pfister SM, Lichter P, Pajtler KW, Weingarten C, Thor T, Kuenkele A, Fleischhack G, Heukamp LC, Buettner R, Kirfel J, Eggert A, Schramm A, Schulte JH, Friedrich C, von Bueren AO, von Hoff K, Gerber NU, Benesch M, Kwiecien R, Pietsch T, Warmuth-Metz M, Faldum A, Kuehl J, Kortmann RD, Rutkowski S, Lupo P, Scheurer M, Martin A, Nirschl C, Polanczyk M, Cohen KJ, Pardoll DM, Drake CG, Lim M, Manoranjan B, Hallett R, Wang X, Venugopal C, McFarlane N, Sheinemann K, Hassell J, Singh S, Venugopal C, Manoranjan B, McFarlane N, Whitton A, Delaney K, Scheinemann K, Singh S, Manoranjan B, Hallett R, Venugopal C, McFarlane N, Hassell J, Scheinemann K, Dunn S, Singh S, Garcia I, Crowther AJ, Gama V, Miller CR, Deshmukh M, Gershon TR, Garcia I, Crowther AJ, Gershon TR, Gerber NU, von Hoff K, Friedrich C, von Bueren AO, Treulieb W, Benesch M, Faldum A, Pietsch T, Warmuth-Metz M, Rutkowski S, Kortmann RD, Zin A, De Bortoli M, Bonvini P, Viscardi E, Perilongo G, Rosolen A, Connolly E, Zhang C, Anderson R, Feldstein N, Stark E, Garvin J, Shing MMK, Lee V, Cheng FWT, Leung AWK, Zhu XL, Wong HT, Kam M, Li CK, Ward S, Sengupta R, Kroll K, Rubin J, Dallas P, Milech N, Longville B, Hopkins R, Vergiliana JVD, Endersby R, Gottardo N, von Bueren AO, Gerss J, Hagel C, Cai H, Remke M, Hasselblatt M, Feuerstein BG, Pernet S, Delattre O, Korshunov A, Rutkowski S, Pfister SM, Baudis M, Lee C, Fotovati A, Triscott J, Dunn S, Valdora F, Freier F, Seyler C, Brady N, Bender S, Northcott P, Kool M, Jones D, Coco S, Tonini GP, Scheurlen W, Boutros M, Taylor M, Katus H, Kulozik A, Zitron E, Korshunov A, Lichter P, Pfister S, Remke M, Shih DJH, Northcott PA, Van Meter T, Pollack IF, Van Meir E, Eberhart CG, Fan X, Dellatre O, Collins VP, Jones DTW, Clifford SC, Pfister SM, Taylor MD, Pompe R, von Bueren AO, von Hoff K, Friedrich C, Treulieb W, Lindow C, Deinlein F, Kuehl J, Rutkowski S, Gupta T, Krishnatry R, Shirsat N, Epari S, Kunder R, Kurkure P, Vora T, Moiyadi A, Jalali R, Cohen K, Perek D, Perek-Polnik M, Dembowska-Baginska B, Drogosiewicz M, Grajkowska W, Lastowska M, Chojnacka M, Filipek I, Tarasinska M, Roszkowski M, Hauser P, Jakab Z, Bognar L, Markia B, Gyorsok Z, Ottoffy G, Nagy K, Cservenyak J, Masat P, Turanyi E, Vizkeleti J, Krivan G, Kallay K, Schuler D, Garami M, Lacroix J, Schlund F, Adolph K, Leuchs B, Bender S, Hielscher T, Pfister S, Witt O, Schlehofer JR, Rommelaere J, Witt H, Leskov K, Ma N, Eberhart C, Stearns D, Dagri JN, Torkildson J, Evans A, Ashby LS, Zakotnik B, Brown RJ, Dhall G, Portnow J, Finlay JL, McCabe M, Pizer B, Marino AM, Baryawno N, Ekstrom TP, Ostman A, Johnsen JI, Robinson G, Parker M, Kranenburg T, Lu C, Pheonix T, Huether R, Easton J, Onar A, Lau C, Bouffet E, Gururangan S, Hassall T, Cohn R, Gajjar A, Ellison D, Mardis E, Wilson R, Downing J, Zhang J, Gilbertson R, Robinson G, Dalton J, O'Neill T, Yong W, Chingtagumpala M, Bouffet E, Bowers D, Kellie S, Gururangan S, Fisher P, Bendel A, Fisher M, Hassall T, Wetmore C, Broniscer A, Clifford S, Gilbertson R, Gajjar A, Ellison D, Zhukova N, Martin D, Lipman T, Castelo-Branco P, Zhang C, Fraser M, Baskin B, Ray P, Bouffet E, Alman B, Ramaswamy V, Dirks P, Clifford S, Rutkowski S, Pfister S, Bristow R, Taylor M, Malkin D, Hawkins C, Tabori U, Dhall G, Ji L, Haley K, Gardner S, Sposto R, Finlay J, Leary S, Strand A, Ditzler S, Heinicke G, Conrad L, Richards A, Pedro K, Knoblaugh S, Cole B, Olson J, Yankelevich M, Budarin M, Konski A, Mentkevich G, Stefanits H, Ebetsberger-Dachs G, Weis S, Haberler C, Milosevic J, Baryawno N, Sveinbjornsson B, Martinsson T, Grotzer M, Johnsen JI, Kogner P, Garzia L, Morrisy S, Jelveh S, Lindsay P, Hill R, Taylor M, Marks A, Zhang H, Rood B, Williamson D, Clifford S, Aurtenetxe O, Gaffar A, Lopez JI, Urberuaga A, Navajas A, O'Halloran K, Hukin J, Singhal A, Dunham C, Goddard K, Rassekh SR, Davidson TB, Fangusaro JR, Ji L, Sposto R, Gardner SL, Allen JC, Dunkel IJ, Dhall G, Finlay JL, Trivedi M, Tyagi A, Goodden J, Chumas P, O'kane R, Crimmins D, Elliott M, Picton S, Silva DS, Viana-Pereira M, Stavale JN, Malheiro S, Almeida GC, Clara C, Jones C, Reis RM, Spence T, Sin-Chan P, Picard D, Ho KC, Lu M, Huang A, Bochare S, Khatua S, Gopalakrishnan V, Chan TSY, Picard D, Pfister S, Hawkins C, Huang A, Chan TSY, Picard D, Ho KC, Huang A, Picard D, Millar S, Hawkins C, Rogers H, Kim SK, Ra YS, Fangusaro J, Toledano H, Nakamura H, Van Meter T, Pomeroy S, Ng HK, Jones C, Gajjar A, Clifford S, Pfister S, Eberhart C, Bouffet E, Grundy R, Huang A, Sengupta S, Weeraratne SD, Phallen J, Sun H, Rallapalli S, Amani V, Pierre-Francois J, Teider N, Cook J, Jensen F, Lim M, Pomeroy S, Cho YJ. MEDULLOBLASTOMA. Neuro Oncol 2012; 14:i82-i105. [PMCID: PMC3483339 DOI: 10.1093/neuonc/nos093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
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Kiyotani C, Uno T, Ogiwara H, Morota N, Nakazawa A, Tsutsumi Y, Masaki H, Mori T, Sanz JAS, Guibelalde M, Tavera A, Herandez I, Ibanez J, Brell M, Mas A, Muller HL, Gebhardt U, Warmuth-Metz M, Pietsch T, Sorensen N, Kortmann RD, Stapleton S, Gonzalez I, Steinbrueck S, Rodriguez L, Tuite G, Krzyzankova M, Mertsch S, Jeibmann A, Kordes U, Wolff J, Paulus W, Hasselblatt M, Nonaka Y, Hara S, Fukazawa S, Shimizu K, Ben-Arush M, Postovsky S, Toledano H, Peretz-Nahum M, Fujimura J, Sakaguchi S, Kondo A, Saito Y, Shimoji K, Ohara Y, Arakawa A, Saito M, Shimizu T, Benesch M, von Bueren AO, Dantonello T, von Hoff K, Pietsch T, Leuschner I, Claviez A, Bierbach U, Kropshofer G, Korinthenberg R, Graf N, Suttorp M, Kortmann RD, Friedrich C, Klingebiel T, Koscielniak E, Rutkowski S, Mesa M, Sanchez M, Mejia J, Pena G, Dussan R, Cabeza M, Storino A, Dincer F, Roffidal T, Powell M, Berrak S, Wolff JE, Fouyssac F, Delaunay C, Vignaud JM, Schmitt E, Klein O, Mansuy L, Chastagner P, Cruz O, Guillen A, Garcia G, Alamar M, Candela S, Roussos I, Garzon M, Sunol M, Muchart J, Rebollo M, Mora J, Wolff J, Diez B, Muggeri A, Arakaki N, Meli F, Sevlever G, Tsitouras V, Pettorini B, Fellows G, Blair J, Didi M, Daousi C, Steele C, Javadpour M, Sinha A, Hishii M, Kondo A, Fujimura J, Sakaguchi S, Ishii H, Shimoji K, Miyajima M, Arai H, Dvir R, Sayar D, Levin D, Ben-Sirah L, Constantini S, Elhasid R, Gertsch E, Foreman N, Valera ET, Brassesco MS, Machado HR, Oliveira RS, Santos AC, Terra VC, Barros MV, Scrideli CA, Tone LG, Merino D, Pienkowska M, Shlien A, Tabori U, Gilbertson R, Malkin D, Jeeva I, Chang B, Long V, Picton S, Burton D, Clark S, Kwok C, Mokete B, Rafiq O, Simmons I, Shing MMK, Li CK, Chan GCF, Ha SY, Yuen HL, Luk CW, Li CK, Ling SC, Li RCH, Yoon JH, Park HJ, Shin HJ, Park BK, Kim JY, Jung HL, Ra YS, Ghim TT, Wolff J, Hasselblatt M, Hartung S, Powell M, Garami M, Traunecker H, Thall P, Mahajan A, Kordes U, Sumerauer D, Grillner P, Orrego A, Mosskin M, Gustavsson B, Holm S, Peters N, Rogers M, Chowdry S, Selman W, Mitchell A, Bangert B, Ahuja S, Laschinger K, Gold D, Stearns D, Wright K, Gupta K, Klimo P, Ellison D, Keating G, Eckel L, Giannini C, Wetjen N, Patton A, Zaky W, McComb G, Finlay J, Grimm J, Wong K, Dhall G, Zaky W, Gilles F, Grimm J, Dhall G, Finlay J, Ormandy D, Alston R, Estlin E, Gattamaneni R, Birch J, Kamaly-Asl I, Hemenway M, Foreman N, Rush S, Reginald YA, Nicolin G, Bartel U, Buncic JR, Aguilera D, Flamini R, Mazewski C, Schniederjan M, Hayes L, Boydston W, MacDonald T, Fleming A, Jabado N, Saint-Martin C, Albrecht S, Ramsay DA, Farmer JP, Bendel A, Hansen M, Dugan S, Mendelsohn N. RARE TUMORS. Neuro Oncol 2012; 14:i148-i156. [PMCID: PMC3483354 DOI: 10.1093/neuonc/nos108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
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Yang QY, Chen ZP, Hayase T, Gomi A, Higaki A, Kawahara Y, Kobari T, Fukuda T, Kashii Y, Morimoto A, Sakatani T, Momoi MY, Murray M, Hale J, Heinemann K, Saran F, Calaminus G, Nicholson J, Murray M, Heinemann K, Hale J, Saran F, Nicholson J, Calaminus G, Martinez S, Khakoo Y, Gilheeney S, Kramer K, Wolden S, Souweidane M, Dunkel I, Brichtova E, Pavelka Z, Bobekova A, Magnova O, Kren L, Svoboda T, Sprlakova A, Slampa P, Zitterbart K, Sterba J, Campen CJ, Ashby D, Fisher PG, Monje M, Dagri J, Torkildson J, Cheng J, Wang RX, Yock T, Banerjee A, Dhall G, Finlay J, Yanagisawa T, Fukuoka K, Suzuki T, Kohga T, Wakiya K, Adachi J, Mishima K, Fujimaki T, Matsutani M, Nishikawa R, Matsutani M, Calaminus G, Frappaz D, Kortmann RD, Alapetite C, Garre ML, Ricardi U, Saran FH, Nicholson J, Calaminus G, Nicholson J, Alapetite C, Kortmann RD, Garre ML, Ricardi U, Saran FH, Frappaz D, Czech T, Nicholson J, Frappaz D, Kortmann RD, Alapetite C, Garre ML, Ricardi U, Saran FH, Calaminus G, Walker R, Hale J, Koga T, Suzuki T, Nishikawa R, Yanagisawa T, Fukuoka K, Matsutani M, Legault G, Allen J, Geludkova O, Mushinskaya M, Kushel Y, Korshunov A, Melikyan A, Shishkina L, Oserova V, Oserov S, Maserkina N, Borodina I, Kumirova E, Boyarchuk N, Gorbatyh S, Popova E, Sherbenko O, Zelinskaya N, Shammasov R, Privalova L, Chulkov O, Kosel Y, Cappellano AM, Paiva P, Cavalheiro S, Dastoli P, Seixas MT, Silva NS, Chan GCF, Shing MMK, Yuen HL, Li RCH, Li CK, Ha SY, Li CK, Chen HH, Chang FC, Chen YW, Wong TT, Yarascavitch B, Stein N, Ribeiro L, Whitton A, Duckworth J, Scheinemann K, Singh S, Geludkova O, Shishkina L, Ozerov S, Gorelyshev S, Maserkina N, Trunin Y, Mushinskaya M, Boyarchuk N, Borodina I, Kagawa N, Fujimoto Y, Hirayama R, Chiba Y, Kijima N, Arita H, Kinoshita M, Hashimoto N, Maruno M, Yoshimine T, Guerra GP, Oscanoa M, Cavero L, Yabar A, Ugarte E, Trivedi M, Tyagi A, Goodden J, Chumas P, Elliott M, Picton S, Robison N, Prabhu S, Sun P, Chi S, Kieran M, Manley P, Cohen L, Goumnerova L, Smith E, Scott M, London W, Ullrich NJ. GERM CELL TUMORS. Neuro Oncol 2012; 14:i49-i55. [PMCID: PMC3483347 DOI: 10.1093/neuonc/nos101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2023] Open
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Pizer B, Donachie PHJ, Robinson K, Taylor RE, Michalski A, Punt J, Ellison DW, Picton S. Treatment of recurrent central nervous system primitive neuroectodermal tumours in children and adolescents: results of a Children's Cancer and Leukaemia Group study. Eur J Cancer 2011; 47:1389-97. [PMID: 21474302 DOI: 10.1016/j.ejca.2011.03.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 02/14/2011] [Accepted: 03/03/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND The treatment of previously irradiated patients with recurrent central nervous system primitive neuroectodermal tumours (PNETs) is a considerable challenge. A study was undertaken to attempt to improve the outcome for such patients using a high dose chemotherapy (HDCT) based strategy. METHODS Between 2000 and 2007, 40 patients with relapsed medulloblastoma (MB) and 5 with relapsed supratentorial PNETs (StPNETs) were accrued. All but one had received prior craniospinal radiotherapy. Patients were initially treated with cyclophosphamide (4 g/m(2)) together with surgery or local radiotherapy where appropriate. If complete or near complete remission was achieved, the patient proceeded to receive two sequential courses of HDCT with stem cell rescue. The first course consisted of thiotepa (900 mg/m(2)) and the second carboplatin (AUC 21). RESULTS All five patients with StPNET died of tumour progression with a median OS of 0.4 years. Nineteen of the 40 patients with relapsed MB underwent surgery. Radiotherapy was administered to eight patients. All patients received at least one course of cyclophosphamide. Only 22 MB patients progressed to the HDCT phase; 10 patients received thiotepa only and 12 thiotepa and carboplatin. At a median follow-up of 7.4 years (Range 2.8-8.2 years), only three MB patients are still alive, one following a further relapse. Three and 5 year OS was 22.0% and 8.2%, respectively and 3 and 5 year EFS was 14.6% and 8.7%, respectively. CONCLUSION This national study based on a strategy including a particular tandem HDCT regimen showed no benefit for previously irradiated patients with relapsed StPNET and very limited benefit for patients with relapsed medulloblastoma.
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Affiliation(s)
- Barry Pizer
- Oncology Unit, Alder Hey Children's Hospital, Eaton Road, Liverpool L12 2AP, United Kingdom.
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Michalski A, Bouffet E, Taylor RE, Hargrave D, Walker D, Picton S, Robinson K, Pizer B, Bujkiewicz S. The addition of high-dose tamoxifen to standard radiotherapy does not improve the survival of patients with diffuse intrinsic pontine glioma. J Neurooncol 2010; 100:81-8. [PMID: 20238235 DOI: 10.1007/s11060-010-0141-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Accepted: 02/07/2010] [Indexed: 10/19/2022]
Abstract
The study aimed to examine the tolerability of the combination of radiotherapy and tamoxifen and the effect on median and event free survival as well as collecting data on the use of steroids in this population. 31 patients with diffuse intrinsic pontine glioma, diagnosed on clinical and radiological criteria, were treated with high-dose oral tamoxifen (120 mg/m(2)/day) given concomitantly with standard dose radiotherapy (54 Gy in 1.8 Gy fractions over 6 weeks). Results Tamoxifen was well tolerated with no grade 3 or 4 CTC toxicity reported. At 1 year, the progression free and event free survival were 3.2% (95% CI: 0.2-14.1%), and at 6 months 19.4% (CI: 7.9% to 34.6%). The overall survival at 1 year was 16.1% (CI: 5.9-30.9%) with median survival 6.32 months. In this study, in which tamoxifen was used in conjunction with radiotherapy, progression free survival was shown to be less good when compared with historical data HR = 3.1 (CI: 1.7-5.7). There was no significant reduction in overall survival. The addition of high-dose tamoxifen, although well tolerated, confers no clinical benefit to patients treated with diffuse intrinsic pontine glioma treated with standard radiotherapy.
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Affiliation(s)
- Antony Michalski
- Department of Oncology, Great Ormond Street Hospital, London, WC1N 3JH, England, UK.
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Ansell P, Johnston T, Simpson J, Crouch S, Roman E, Picton S. Brain tumor signs and symptoms: analysis of primary health care records from the UKCCS. Pediatrics 2010; 125:112-9. [PMID: 20026498 DOI: 10.1542/peds.2009-0254] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To compare the frequency of brain tumor signs and symptoms in children with and without brain tumors. METHODS This was a UK population-based retrospective analysis of primary care records. Participants were 195 children (1-14 years) newly diagnosed with brain tumors and 285 controls matched by age, gender, and region. Comparisons included total number of prediagnosis consultations, number with >or=1 symptom suggestive of a brain tumor, total number of symptoms, number of different symptoms, and number of visits with specific combinations of symptoms. RESULTS On average, cases consulted more often than controls between birth and diagnosis/pseudodiagnosis with brain tumor signs and symptoms. Their consultation rate with >or=1 suggestive symptom escalated in the 2 years before diagnosis. Symptom prevalence was higher among cases than controls, a relative difference of 3.29 times as many consultations with >or=1 suggestive symptom (95% confidence interval [CI]: 2.82-3.83) and 7.01 as many with more than 1 (95% CI: 5.38-9.13). In each 6-month period in the 4 years before diagnosis, cases had at least twice as many consultations with >or=1 suggestive symptom (20.81 times as many in the 6 months before diagnosis [95% CI: 14.29-30.30]) and 2-3 times more records of suggestive symptoms (28.35 times more in the 6 months before diagnosis [95% CI: 19.05-42.19]). Symptoms rarely or not observed among control children included head tilt, odd head movements, odd posture, back or neck stiffness, and unsteadiness without obvious cause. CONCLUSION Key to identifying the 1 child among many who merits prompt investigation is recognition of unusual symptoms, or specific symptom patterns.
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Affiliation(s)
- Pat Ansell
- Department of Health Sciences, University of York, York, United Kingdom.
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Ward E, Hopkins M, Arbuckle L, Williams N, Forsythe L, Bujkiewicz S, Pizer B, Estlin E, Picton S. Nutritional problems in children treated for medulloblastoma: implications for enteral nutrition support. Pediatr Blood Cancer 2009; 53:570-5. [PMID: 19530236 DOI: 10.1002/pbc.22092] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of this study was to identify the nature and severity of nutritional problems associated with the current treatment of medulloblastoma and to identify any risk factors for nutritional morbidity during treatment. PROCEDURE A multicentre retrospective audit of medical and dietetic notes of 41 children treated for medulloblastoma in three UK paediatric oncology centres was undertaken. Data on nutritional status, nutritional support, mutism, swallowing and common toxicity criteria (CTC) scores for vomiting, constipation and mobility were collected at defined points in treatment from diagnosis until 12 months post-treatment. RESULTS Significant problems including weight loss, vomiting and constipation were highlighted early on in treatment. The majority of patients were well nourished at diagnosis with a mean percentage weight: height of 99.8%, however nutritional status started to decline early in treatment during radiotherapy, coinciding with 49% of patients having grade 1 or above CTC score for vomiting and constipation. The decline in nutritional status continued, peaking by course 2 of chemotherapy with a mean weight loss of 8.2% since diagnosis. Proactive supplementary feeding early in treatment by one of the three centres demonstrated a superior nutritional outcome when compared statistically to the two centres that fed only as a response to nutritional decline. CONCLUSION The study highlighted significant morbidity associated with the current treatment of medulloblastoma. Findings suggest the need to consider earlier proactive nutritional intervention to prevent nutritional decline during treatment. These early nutritional problems may be related to toxicities of radiotherapy and concomitant vincristine.
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Affiliation(s)
- Evelyn Ward
- Dietetic Department, St James's University Hospital, Leeds, UK.
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Messahel B, Ashley S, Saran F, Ellison D, Ironside J, Phipps K, Cox T, Chong W, Robinson K, Picton S, Pinkerton C, Mallucci C, Macarthur D, Jaspan T, Michalski A, Grundy R. Relapsed intracranial ependymoma in children in the UK: Patterns of relapse, survival and therapeutic outcome. Eur J Cancer 2009; 45:1815-23. [DOI: 10.1016/j.ejca.2009.03.018] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2008] [Revised: 03/08/2009] [Accepted: 03/17/2009] [Indexed: 10/20/2022]
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Phillips RS, Tyerman K, Al-Kassim MI, Picton S. A systematic review of the accuracy and utility of early markers of Ifosfamide-induced proximal tubulopathy in survivors of childhood cancers. Pediatr Hematol Oncol 2008; 25:107-13. [PMID: 18363176 DOI: 10.1080/08880010701885276] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study was conducted to identify and assess the accuracy and utility of any early markers of clinically significant proximal tubulopathy in children treated with ifosfamide chemotherapy. Ifosfamide is widely used either as a solitary agent or in conjunction with various other chemotherapeutic agents in treating solid tumors of childhood. It is highly effective but can cause short-term and long-term damage to kidneys, most commonly resulting in a tubular nephropathy and/or glomerular dysfunction. This may lead to chronic renal failure and metabolic bone disease in long-term survivors of childhood cancer. Multiple electronic databases (Cochrane, MEDLINE, EMBASE) were searched for primary studies describing the predictive value of early blood or urine tests to predict proximal tubulopathy. Citation searching (using reference lists and Science Citation Index searches) was also undertaken. Analysis was undertaken using criteria suggested by the MOOSE (Meta-analysis of Observational Studies in Epidemiology) collaboration. Studies were reviewed by at least 2 authors and disagreements resolved by consensus. Initial searches revealed approximately 310 studies of which 38 papers were selected for full analysis. Only 4 papers described the predictive value of early markers proximal tubular nephropathy. The remaining studies estimated prevalence of acute or chronic nephropathy without presenting predictive data. Of the 4 papers selected for analysis, 2 papers assessed the value of beta-2 microglobulinuria, and 3 addressed quantitative aminoaciduria. Test characteristics ranged from sensitivities of 82 to 100% and specificities of 84 to 100%, although the confidence intervals around these estimates were wide. Given the paucity of data, to consider further the use of early markers of proximal tubular nephropathy a prospective evaluation of patients who have been treated with ifosfamide based regimes should be undertaken.
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Affiliation(s)
- Robert S Phillips
- Regional Department of Paediatric Haematology/Oncology, St James's Hospital, Leeds, UK.
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Affiliation(s)
- B Phillips
- Department of Paediatric Oncology, St James' University Hospital, Leeds, UK
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Grill J, Lowis S, Frappaz D, Michalski A, Picton S, Jouvet A, Robson K, Jaspan T, Couanet D, Le Deley M. Phase II study of the combination of cisplatin + temozolomide in malignant glial tumours in children and adolescents at diagnosis or in relapse (cistem2/nct00147160). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.9543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9543 Background: Temozolomide has been shown moderately effective in pediatric high-grade glioma (HGG). By decreasing the activity of MGMT, principal mechanism of resistance to temozolomide, cisplatin may increase the activity of this alkylating agent. Methods: Patients aged 4 to 21y with HGG outside the brainstem were treated at diagnosis or at relapse every 28 days with a combination of cisplatin 80 mg/m2 intravenously on day-1 and temozolomide 200 mg/m2 orally on days 2–6, according to the pediatric phase I recommendations. Patients treated at diagnosis had to proceed to involved field radiotherapy after the chemotherapy window. According to initial response, patients were offered additional courses, up to seven. We considered that this combination would be of interest if the response rate was superior or equal to 20%, using a two-stage Simon design in 3 cohorts: evaluable non measurable (infiltrative) at diagnosis (cohort A1); measurable disease (nodular) at diagnosis (A2); recurrent disease (B). The primary endpoint was complete or partial response after two courses, confirmed by central review. Up to 29 evaluable pts were to be entered in each cohort. If fewer than 4/29 responses were observed, it would be concluded that the combination is ineffective. Results: 56 pts were entered from 10/2003 through 07/2006 in 25 centers. One was excluded after central pathology review and 3 due to insufficient radiology work-out. 42 had grade III and 13 grade IV gliomas, including 21 tumors with oligodendroglial features. No response was observed in the first 11 pts in cohort A1 and in the first 12 pts in cohort B. Two partial and 4 minor responses were confirmed in 29 pts of cohort A2 leading to a 7% response rate (95% CI, 1–23%). Median time to progression was 1.7, 7.1 and 6.9 months in cohorts A1, A2 and B, respectively. Toxicity was manageable except in pts with large infiltrative lesions who did not tolerate hydration. Conclusion: CISTEM combination has insufficient efficacy in pediatric compared to adult HGG despite efficient down-regulation of MGMT activity. To overcome resistance to temozolomide in children and adolescents, one may need to target other known resistance mechanisms such as mismatch-repair deficiency. [Table: see text]
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Affiliation(s)
- J. Grill
- Institute Gustave Roussy, Villejuif, France; University Hospital, Bristol, United Kingdom; Centre Leon Berard, Lyon, France; GOSH, London, United Kingdom; University Hospital, Leeds, United Kingdom; Centre Hospitalier, Lyon, France; University Hospital, Nottingham, United Kingdom
| | - S. Lowis
- Institute Gustave Roussy, Villejuif, France; University Hospital, Bristol, United Kingdom; Centre Leon Berard, Lyon, France; GOSH, London, United Kingdom; University Hospital, Leeds, United Kingdom; Centre Hospitalier, Lyon, France; University Hospital, Nottingham, United Kingdom
| | - D. Frappaz
- Institute Gustave Roussy, Villejuif, France; University Hospital, Bristol, United Kingdom; Centre Leon Berard, Lyon, France; GOSH, London, United Kingdom; University Hospital, Leeds, United Kingdom; Centre Hospitalier, Lyon, France; University Hospital, Nottingham, United Kingdom
| | - A. Michalski
- Institute Gustave Roussy, Villejuif, France; University Hospital, Bristol, United Kingdom; Centre Leon Berard, Lyon, France; GOSH, London, United Kingdom; University Hospital, Leeds, United Kingdom; Centre Hospitalier, Lyon, France; University Hospital, Nottingham, United Kingdom
| | - S. Picton
- Institute Gustave Roussy, Villejuif, France; University Hospital, Bristol, United Kingdom; Centre Leon Berard, Lyon, France; GOSH, London, United Kingdom; University Hospital, Leeds, United Kingdom; Centre Hospitalier, Lyon, France; University Hospital, Nottingham, United Kingdom
| | - A. Jouvet
- Institute Gustave Roussy, Villejuif, France; University Hospital, Bristol, United Kingdom; Centre Leon Berard, Lyon, France; GOSH, London, United Kingdom; University Hospital, Leeds, United Kingdom; Centre Hospitalier, Lyon, France; University Hospital, Nottingham, United Kingdom
| | - K. Robson
- Institute Gustave Roussy, Villejuif, France; University Hospital, Bristol, United Kingdom; Centre Leon Berard, Lyon, France; GOSH, London, United Kingdom; University Hospital, Leeds, United Kingdom; Centre Hospitalier, Lyon, France; University Hospital, Nottingham, United Kingdom
| | - T. Jaspan
- Institute Gustave Roussy, Villejuif, France; University Hospital, Bristol, United Kingdom; Centre Leon Berard, Lyon, France; GOSH, London, United Kingdom; University Hospital, Leeds, United Kingdom; Centre Hospitalier, Lyon, France; University Hospital, Nottingham, United Kingdom
| | - D. Couanet
- Institute Gustave Roussy, Villejuif, France; University Hospital, Bristol, United Kingdom; Centre Leon Berard, Lyon, France; GOSH, London, United Kingdom; University Hospital, Leeds, United Kingdom; Centre Hospitalier, Lyon, France; University Hospital, Nottingham, United Kingdom
| | - M. Le Deley
- Institute Gustave Roussy, Villejuif, France; University Hospital, Bristol, United Kingdom; Centre Leon Berard, Lyon, France; GOSH, London, United Kingdom; University Hospital, Leeds, United Kingdom; Centre Hospitalier, Lyon, France; University Hospital, Nottingham, United Kingdom
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