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Curr Treat Options Oncol. 2018 Jun 21;19(8):41. doi: 10.1007/s11864-018-0559-4.

Precision Neuro-oncology: the Role of Genomic Testing in the Management of Adult and Pediatric Gliomas.

Author information

1
University of North Carolina School of Medicine, Chapel Hill, NC, USA.
2
Foundation Medicine, Inc, 7010 Kit Creek Road, Morrisville, NC, 27560, USA.
3
Foundation Medicine, Inc, Cambridge, MA, USA.
4
SUNY Upstate Medical University, Syracuse, NY, USA.
5
Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
6
Section of Pediatric Hematology-Oncology, Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
7
Section of Hematology-Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
8
Foundation Medicine, Inc, 7010 Kit Creek Road, Morrisville, NC, 27560, USA. sramkissoon@foundationmedicine.com.
9
Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA. sramkissoon@foundationmedicine.com.

Abstract

In recent years, large-scale genomic studies have expanded our knowledge regarding genomic drivers in tumors of the central nervous system. While histopathologic analysis of brain tumors remains the primary method for tumor classification, the clinical utility of molecular and genomic testing to support and/or complement tumor classification continues to expand. This approach enhances diagnostic accuracy and provides clinicians with objective data to facilitate discussions regarding prognosis and treatment decisions, including selection of clinical trials. Ensuring accurate diagnoses is fundamental to the management of brain tumor patients. However, given the morphologic overlap among primary brain tumors, genomic data can be used to help distinguish tumor lineage. In its clearest form, we have embraced the concept of an integrated diagnosis, which combines traditional histopathology findings with molecular and genomic data. Patient prognosis varies significantly based on a tumor's genomic profile. For neuro-oncology patients, outcome studies linking diagnoses with genomic profiles show significant differences based on tumor biomarkers such as IDH1/2, H3F3A, BRAF, and CDKN2A and TERT status. Therefore, easy access to reliable genomic data is important in understanding a patient's disease and developing a clinical strategy wherein targeted molecular or immune therapies can be incorporated into the discussion.

KEYWORDS:

Comprehensive genomic profiling; Glioma; Immunotherapy; Targeted therapy

PMID:
29931654
DOI:
10.1007/s11864-018-0559-4
[Indexed for MEDLINE]

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