Study Assessing the Feasibility of a Surgery and Chemotherapy-Only in Children With Wnt Positive Medulloblastoma

Inclusion Criteria

• •Participants must have classical histology posterior fossa medulloblastoma as determined by institutional neuro-pathological evaluation.
• •Sufficient pathologic material must be available for central analysis and review
• •Tumors will be deemed Wnt positive if, at the time of central analysis, there is:
• •Monosomy 6 as determined by array CGH
• •Gene transcript detection by NanoString supporting Wnt+ medulloblastoma
• •Absence of large-cell, anaplastic histology
• •Nuclear b-catenin IHC will be determined, but not required for the diagnosis
• •Absence of residual or disseminated disease as defined by the following criteria: Minimal residual disease as determined by post-operative imaging preferably performed within 48 hours of resection (and at most 28 days post-surgery), i.e. gross total resection or residual disease of \<1.5cm2 on post-operative imaging.
• •No evidence of metastatic disease in the brain, spine or cerebral spinal fluid (CSF). Assessments must include MRI imaging of the brain and spine with and without contrast and a lumbar puncture for CSF cytology
• •Diagnostic imaging (pre and post contrast) must be forwarded to Dana-Farber Cancer Institute (DFCI) for central review to confirm eligibility
• •Patients must not have had any radiation therapy or chemotherapy for medulloblastoma prior to study enrollment
• •Patients must have a Lansky performance status of \>/=30 for children \</=10 years of age or a Karnofsky performance status of \> 30 for children \> 10 years of age.
• •Participants must have normal organ and marrow function as defined below:
• •Hemoglobin greater than 10 g/dL (can be transfused). Hemoglobin \<10 g/dL due to operative blood loss is permitted.
• •Absolute neutrophil count \> 1.0x109/L
• •Platelets \> 100,000/uL (non-transfused)
• •Total bilirubin \<1.5 x upper limit normal
• •SGOT (AST) or SGPT (ALT) \<2.5 x upper limit normal (ULN) for age
• •Creatinine clearance or radioisotope GFR \>70 ml/min/1.73m2 or normal serum creatinine for patient's age and gender
• •All females of child-bearing age must have a negative pregnancy test before being enrolled on study. All patients of child-bearing age must practice an effective method of birth control whilst undergoing chemotherapy on study.
• •No history of allergic reactions attributed to compounds of similar chemical or biologic composition to cisplatin, lomustine, vincristine or cyclophosphamide.