NEOPLASMS: Edited by Riccardo SoffiettiAre molecular subgroups of medulloblastomas really prognostic?Frappaz, Didiera; Faure-Conter, Cécilea; Meyronet, Davidb; Levard-Bonneville, Alicea; Beuriat, Pierre-Aurélienc; Sunyach, Marie P.a; Barritault, Marcb Author Information aIhope and Centre Léon Bérard bHôpital Neurologique cHôpital Femme Mère Enfant, Lyon, France Correspondence to Didier Frappaz, Ihope and Centre Léon Bérard, 28 Rue Laennec, 69673 Lyon, France. E-mail: [email protected] Current Opinion in Neurology: December 2018 - Volume 31 - Issue 6 - p 747-751 doi: 10.1097/WCO.0000000000000626 Buy Metrics Abstract Purpose of review Medulloblastoma is no more a unique disease. Clinical and biologic classification used so far are challenged by molecular classification(s). Following the consensus article that described four molecular groups of medulloblastoma in 2012, several articles in 2017 provided more relevant classifications that may impact on further clinical trial design. Recent findings Though wingless (WNT) and sonic hedgehog (SHH) are defined by the activation of their respective pathways, the age and type of activation define various subgroups with specific features and outcome. Groups 3 and 4 remain ill defined. The whole population of medulloblastoma may be divided in 12 subgroups: WNTαβ, SHHαβγδ, group 3αβγ and group 4αβγ. The paediatric population may be divided in seven subgroups: WNT, SHH of infants and children, and low-risk and high-risk groups 3 and 4. SHH of infants may be divided as iSHH-I vs. iSHH-II that have different prognosis. Moreover, specific drivers of groups 3 and 4 were reported. Summary These findings have and will have direct implications on the conception of clinical trials. Low-risk groups will benefit from less toxic therapies, and high-risk groups will benefit from targeted therapies. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.