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Department of Pediatric Oncology and Hematology, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands (J.M.D., E.M.M., M.L.D., R.P.); Division of Neurology, Brain Tumor Institute, Children's National Medical Center, Washington, DC, USA (R.J.P.)
Address correspondence to Judith M. de Bont, Erasmus MC–Sophia Children's Hospital, Department of Pediatric Oncology and Hematology, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands (j.debont{at}erasmusmc.nl).
Survival rates of pediatric brain tumor patients have significantly improved over the years due to developments in diagnostic techniques, neurosurgery, chemotherapy, radiotherapy, and supportive care. However, brain tumors are still an important cause of cancer-related deaths in children. Prognosis is still highly dependent on clinical characteristics, such as the age of the patient, tumor type, stage, and localization, but increased knowledge about the genetic and biological features of these tumors is being obtained and might be useful to further improve outcome for these patients. It has become clear that the deregulation of signaling pathways essential in brain development, for example, sonic hedgehog (SHH), Wnt, and Notch pathways, plays an important role in pathogenesis and biological behavior, especially for medulloblastomas. More recently, data have become available about the cells of origin of brain tumors and the possible existence of brain tumor stem cells. Newly developed array-based techniques for studying gene expression, protein expression, copy number aberrations, and epigenetic events have led to the identification of other potentially important biological abnormalities in pediatric medulloblastomas and ependymomas.
Key Words: biological characteristics ependymoma epigenetic events gene expression medulloblastoma protein expression signaling pathways
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