{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:00:00Z","timestamp":1790172000536,"version":"4.1.0"},"reference-count":133,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Embryonal tumors comprise the majority of malignant central nervous system (CNS) neoplasms diagnosed in children under 3\u00a0years of age. Compared with their counterparts in older children, these tumors exhibit distinct molecular biology and a more aggressive clinical phenotype, while their management is complicated by the heightened vulnerability of the developing brain to acute toxicity and long\u2010term sequelae from surgery, chemotherapy, and radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To summarize the contemporary understanding of infant CNS embryonal tumors, including molecular classification, treatment paradigms, and emerging therapeutic strategies, and to outline a framework for molecularly driven, risk\u2010adapted management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and Methods<\/jats:title>\n                    <jats:p>We performed a narrative review of published cooperative\u2010group, consortium, and single\u2010institution trials in medulloblastoma, atypical teratoid\/rhabdoid tumor (AT\/RT), embryonal tumor with multilayered rosettes (ETMR), pineoblastoma, and other infant CNS embryonal entities, integrating findings with the 2021 WHO Classification of CNS Tumors and recent DNA methylation\u2010 and next\u2010generation sequencing\u2010based subclassifications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Molecular profiling has reshaped diagnosis and risk stratification across all infant embryonal entities, identifying clinically actionable subgroups (e.g., SHH\u2010I\/II in medulloblastoma; AT\/RT\u2010TYR, \u2010SHH, \u2010MYC; ETMR with C19MC or\n                      <jats:italic>DICER1<\/jats:italic>\n                      alterations; pineoblastoma molecular subgroups). Multimodal regimens that delay or avoid craniospinal irradiation have achieved durable survival in favorable\u2010risk SHH\u2010activated medulloblastoma, while outcomes remain poor for Group 3 medulloblastoma, ETMR, pineoblastoma, and metastatic AT\/RT. Investigational targeted and immunotherapeutic strategies, intraventricular methotrexate, proton\u2010beam radiotherapy, and cerebrospinal fluid liquid biopsy are increasingly being incorporated into risk\u2010adapted approaches.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Molecularly driven, risk\u2010adapted clinical trials and international collaborative registries are essential to advance care for infants with CNS embryonal tumors, with the dual goals of improving survival and reducing treatment\u2010related neurodevelopmental morbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70624","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T13:51:11Z","timestamp":1787233871000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Infant Embryonal CNS Tumors: Molecular Insights and Treatment Considerations for Contemporary Pediatric Neuro\u2010Oncology"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4738-6356","authenticated-orcid":false,"given":"Sudarshawn","family":"Damodharan","sequence":"first","affiliation":[{"name":"Division of Pediatric Hematology and Oncology University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6163-6991","authenticated-orcid":false,"given":"Mariah","family":"Wright\u2010Nadkarni","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology Advocate Health Wake Forest Baptist  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8262-7469","authenticated-orcid":false,"given":"Mohamed S.","family":"Abdelbaki","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9206-8259","authenticated-orcid":false,"given":"Girish","family":"Dhall","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology Oncology and Blood &amp; Marrow Transplantation Children's of Alabama at University of Alabama  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073808321769"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11040670"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2116344"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2024.09.031"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noab106"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz164"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noad124"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401\u2010010\u20100751\u20105"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428\u2010023\u201003632\u20104"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17091566"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401\u2010022\u201002405\u20108"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature26000"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2011.09.012"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(15)00581\u20101"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/nox222"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spen.2025.101181"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12071050"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jncc.2023.03.001"},{"key":"e_1_2_14_20_1","article-title":"Therapeutic Outcomes and Toxicity Mitigation of Proton Beam Therapy in Pediatric Neuro\u2010Oncology: A Systematic Review","volume":"17","author":"Patel K. 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