Approach to integrating molecular markers for assessment of pediatric gliomas

Abstract

Recent research has promoted elucidation of the diverse biological processes that occur in pediatric central nervous system (CNS) tumors. These molecular data are leading to new guidelines for the diagnosis, offering prognostic implications and novel molecular targeted therapies. The consortium to inform molecular and practical approaches to CNS tumor taxonomy-NOW have made practical recommendations using recent advances in CNS tumor classification, particularly in molecular discernment of these neoplasms as morphology-based classification of tumors is being replaced by molecular-based classification. Here, we review the specific molecular drivers that help to define the entities that fall under the umbrella of pediatric gliomas and how to effectively test them in cost-effective manner. We discuss briefly the proposed risk-based stratification system that considers both clinical and molecular parameters to aid clinicians in making treatment decisions and the availability of an increasing array of molecular-directed therapies.