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Cold Spring Harb Mol Case Stud. 2019 Aug 1;5(4). pii: a004143. doi: 10.1101/mcs.a004143. Print 2019 Aug.

The pivotal role of sampling recurrent tumors in the precision care of patients with tumors of the central nervous system.

Author information

1
Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada.
2
Molecular Oncology, BC Cancer, Vancouver, British Columbia V5Z 1L3, Canada.
3
Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, British Columbia V5Z 4S6, Canada.
4
Division of Medical Oncology, BC Cancer, Vancouver, British Columbia V5Z 4E6, Canada.
5
Department of Neurosurgery, University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada.

Abstract

Effective management of brain and spine tumors relies on a multidisciplinary approach encompassing surgery, radiation, and systemic therapy. In the era of personalized oncology, the latter is complemented by various molecularly targeting agents. Precise identification of cellular targets for these drugs requires comprehensive profiling of the cancer genome coupled with an efficient analytic pipeline, leading to an informed decision on drug selection, prognosis, and confirmation of the original pathological diagnosis. Acquisition of optimal tumor tissue for such analysis is paramount and often presents logistical challenges in neurosurgery. Here, we describe the experience and results of the Personalized OncoGenomics (POG) program with a focus on tumors of the central nervous system (CNS). Patients with recurrent CNS tumors were consented and enrolled into the POG program prior to accrual of tumor and matched blood followed by whole-genome and transcriptome sequencing and processing through the POG bioinformatic pipeline. Sixteen patients were enrolled into POG. In each case, POG analyses identified genomic drivers including novel oncogenic fusions, aberrant pathways, and putative therapeutic targets. POG has highlighted that personalized oncology is truly a multidisciplinary field, one in which neurosurgeons must play a vital role if these programs are to succeed and benefit our patients.

KEYWORDS:

neoplasm of the central nervous system; neoplasm of the peripheral nervous system

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