Molecular testing for adolescent and young adult central nervous system tumors: A Canadian guideline.

The 2021 World Health Organization (WHO) classification of CNS tumors incorporates molecular signatures with histology and has highlighted differences across pediatric vs adult-type CNS tumors. However, adolescent and young adults (AYA; aged 15-39), can suffer from tumors across this spectrum and is a recognized orphan population that requires multidisciplinary, specialized care, and often through a transition phase. To advocate for a uniform testing strategy in AYAs, pediatric and adult specialists from neuro-oncology, radiation oncology, neuropathology, and neurosurgery helped develop this review and testing framework through the Canadian AYA Neuro-Oncology Consortium. We propose a comprehensive approach to molecular testing in this unique population, based on the recent tumor classification and within the clinical framework of the provincial health care systems in Canada. While there are guidelines for testing in adult and pediatric CNS tumor populations, there is no consensus testing for AYA patients whose care occur in both pediatric and adult hospitals. Our review of the literature and guideline adopts a resource-effective and clinically-oriented approach to improve diagnosis and prognostication of brain tumors in the AYA population, as part of a nation-wide initiative to improve care for AYA patients.

Informations de copyright

Copyright © 2022 Lim-Fat, Macdonald, Lapointe, Climans, Cacciotti, Chahal, Perreault, Tsang, Gao, Yip, Keith, Bennett, Ramaswamy, Detsky, Tabori, Das and Hawkins.

Déclaration de conflit d'intérêts

SY is a member of advisory board of Amgen, AstraZeneca, Bayer, Incyte, and Roche. Sunit Das receives laboratory research funding from Alkermes. He is a speaker for the Congress of Neurological Surgeons and American Association of Neurological Surgeons. He is a member of the advisory board of the Subcortical Surgery Group and Xpan Medical. He serves as the Provincial Lead for CNS Tumours at Ontario Health (Cancer Care Ontario). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.