Surgery and Combination Chemotherapy in Treating Younger Patients with Non-metastatic Standard-Risk Medulloblastoma

Inclusion Criteria

• SCREENING:
• 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 comparative genomic hybridization (CGH) * Gene transcript detection by NanoString supporting Wnt+ medulloblastoma * Absence of large-cell, anaplastic histology * Nuclear b-catenin immunohistochemistry (IHC) result will be determined, but not required for the diagnosis
• TREATMENT:
• 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 < 1.5 cm^2 on post-operative imaging
• No evidence of metastatic disease in the brain, spine or cerebrospinal fluid (CSF); assessments must include magnetic resonance imaging (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
• Hemoglobin greater than 10 gm/dL (can be transfused); hemoglobin < 10 gm/dL due to operative blood loss is permitted
• Absolute neutrophil count >= 1,000/uL
• Platelets >= 100,000/uL (non-transfused)
• Total bilirubin < 1.5 x upper limit normal
• Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) or serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) < 2.5 x upper limit normal for age
• Creatinine clearance or radioisotope glomerular filtration rate (GFR) > 70 ml/min/1.73 m^2 or normal serum creatinine for patient’s age and gender
• Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) for the duration of study participation; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately; pregnant or breast-feeding females are not eligible for study enrollment; 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 (vincristine sulfate) or cyclophosphamide
• Ability to understand and the willingness to sign a written informed consent document for both screening and treatment; signed informed consent must be obtained prior to screening or treatment
• All Institutional, Food and Drug Administration (FDA) and National Cancer Institute (NCI) requirements for human studies must be met
• Eligibility criteria cannot be waived