Chemotherapy Strategies in Pediatric Neuro-Oncology

Pediatric neuro-oncology demands a delicate balance between efficacy and minimising long-term sequelae in developing brains. Chemotherapy remains integral across multiple tumour types such as medulloblastoma, ependymoma and high-grade glioma. Standard protocols often combine alkylating agents, topoisomerase inhibitors and platinum compounds, guided by molecular subgrouping and risk stratification. High-dose regimens with autologous stem cell rescue have been employed to intensify therapy while sparing radiotherapy in very young children, though at the cost of increased toxicity. Metronomic approaches maintain continuous low-dose exposure to disrupt angiogenesis and tumour proliferation with improved tolerability. Recent advances in genomic profiling have facilitated the integration of targeted agents into early-phase trials, with a growing emphasis on combination regimens that exploit tumour vulnerabilities. Efforts to personalise second-line treatments at relapse focus on re-induction protocols that achieve disease control prior to consolidation. Ongoing research seeks to refine the timing, dosing and sequencing of agents to maximise survival and quality of life.

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Chemotherapy Strategies in Pediatric Neuro-Oncology publication trend

The graph below shows the total number of articles in chemotherapy strategies in pediatric neuro-oncology across all publications each year (not limited to Nature Index journals).

Technical terms

Autologous stem cell rescue: Harvesting and reinfusion of a patient’s own stem cells following high-dose chemotherapy to restore bone marrow function.

Metronomic chemotherapy: Continuous or frequent administration of low-dose chemotherapeutic agents aimed at antiangiogenic effects and reduced toxicity.

Alkylating agent: A class of chemotherapy drugs that induce DNA crosslinks, preventing tumour cell replication.

Re-induction: A second course of intensive chemotherapy given at tumour relapse to achieve renewed disease control.

Progression-free survival: The duration in which a patient’s disease does not worsen following treatment.

References

1. Effective re-induction regimen for children with recurrent medulloblastoma. Neuro-Oncology Advances (2024).
2. Improved Long-Term Survival of Patients with Recurrent Medulloblastoma Treated with a “MEMMAT-like” Metronomic Antiangiogenic Approach. Cancers (2022).
3. High-Dose Chemotherapy in Children with Newly Diagnosed Medulloblastoma. Cancers (2022).