Diagnostic, therapeutic, and prognostic implications of the 2021 World Health Organization classification of tumors of the central nervous system

The 2016 revised fourth edition of the World Health Organization (WHO) classification of central nervous system (CNS) tumors incorporated molecular features with histologic grading, revolutionizing how oncologists conceptualize primary brain and spinal cord tumors as well as providing new insights i...

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Published in:	Cancer Vol. 128; no. 1; pp. 47 - 58
Main Authors:	Gritsch, Simon, Batchelor, Tracy T., Gonzalez Castro, L. Nicolas
Format:	Journal Article
Language:	English
Published:	United States Wiley Subscription Services, Inc 01.01.2022
Subjects:	2021 World Health Organization (WHO) central nervous system (CNS) tumor classification Adult Astrocytoma Brain cancer Brain Neoplasms - diagnosis Brain Neoplasms - therapy Brain tumors Central nervous system Central Nervous System - pathology Central Nervous System Neoplasms - diagnosis Central Nervous System Neoplasms - genetics Central Nervous System Neoplasms - therapy Child Classification Clinical trials glioblastoma Glioma Glioma - pathology Humans isocitrate dehydrogenase (IDH)‐mutant gliomas Isocitrate Dehydrogenase - genetics Medical diagnosis Medical prognosis meningiomas Mutation Nervous system Oncology Pathophysiology Pediatrics Prognosis Spinal cord Tumors World Health Organization glioma 2021 World Health Organization (WHO) central nervous system (CNS) tumor classification glioblastoma meningiomas isocitrate dehydrogenase (IDH)-mutant gliomas
ISSN:	0008-543X, 1097-0142, 1097-0142
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Abstract	The 2016 revised fourth edition of the World Health Organization (WHO) classification of central nervous system (CNS) tumors incorporated molecular features with histologic grading, revolutionizing how oncologists conceptualize primary brain and spinal cord tumors as well as providing new insights into their management and prognosis. The 2021 revised fifth edition of the WHO classification further integrates molecular alterations for CNS tumor categorization, updating current understanding of the pathophysiology of many of these disease entities. Here, the authors review changes in the new classification for the most common primary adult tumors—gliomas (including astrocytomas, oligodendrogliomas, and ependymomas) and meningiomas—highlighting the key genomic alterations for each group classification to help clinicians interpret them as they consider therapeutic options—including clinical trials and targeted therapies—and discuss the prognosis of these tumors with their patients. The revised, updated 2021 WHO classification also further integrates molecular alterations in the classification of pediatric CNS tumors, but those are not covered in the current review. The 2021 World Health Organization classification of tumors of the central nervous system increasingly relies on molecular alterations for central nervous system tumor categorization. The new classification will help improve diagnosis, prognosis, and treatment selection (including enrollment into relevant clinical trials) for patients with brain tumors.
AbstractList	The 2016 revised fourth edition of the World Health Organization (WHO) classification of central nervous system (CNS) tumors incorporated molecular features with histologic grading, revolutionizing how oncologists conceptualize primary brain and spinal cord tumors as well as providing new insights into their management and prognosis. The 2021 revised fifth edition of the WHO classification further integrates molecular alterations for CNS tumor categorization, updating current understanding of the pathophysiology of many of these disease entities. Here, the authors review changes in the new classification for the most common primary adult tumors—gliomas (including astrocytomas, oligodendrogliomas, and ependymomas) and meningiomas—highlighting the key genomic alterations for each group classification to help clinicians interpret them as they consider therapeutic options—including clinical trials and targeted therapies—and discuss the prognosis of these tumors with their patients. The revised, updated 2021 WHO classification also further integrates molecular alterations in the classification of pediatric CNS tumors, but those are not covered in the current review. The 2021 World Health Organization classification of tumors of the central nervous system increasingly relies on molecular alterations for central nervous system tumor categorization. The new classification will help improve diagnosis, prognosis, and treatment selection (including enrollment into relevant clinical trials) for patients with brain tumors. The 2016 revised fourth edition of the World Health Organization (WHO) classification of central nervous system (CNS) tumors incorporated molecular features with histologic grading, revolutionizing how oncologists conceptualize primary brain and spinal cord tumors as well as providing new insights into their management and prognosis. The 2021 revised fifth edition of the WHO classification further integrates molecular alterations for CNS tumor categorization, updating current understanding of the pathophysiology of many of these disease entities. Here, the authors review changes in the new classification for the most common primary adult tumors—gliomas (including astrocytomas, oligodendrogliomas, and ependymomas) and meningiomas—highlighting the key genomic alterations for each group classification to help clinicians interpret them as they consider therapeutic options—including clinical trials and targeted therapies—and discuss the prognosis of these tumors with their patients. The revised, updated 2021 WHO classification also further integrates molecular alterations in the classification of pediatric CNS tumors, but those are not covered in the current review. The 2016 revised fourth edition of the World Health Organization (WHO) classification of central nervous system (CNS) tumors incorporated molecular features with histologic grading, revolutionizing how oncologists conceptualize primary brain and spinal cord tumors as well as providing new insights into their management and prognosis. The 2021 revised fifth edition of the WHO classification further integrates molecular alterations for CNS tumor categorization, updating current understanding of the pathophysiology of many of these disease entities. Here, the authors review changes in the new classification for the most common primary adult tumors-gliomas (including astrocytomas, oligodendrogliomas, and ependymomas) and meningiomas-highlighting the key genomic alterations for each group classification to help clinicians interpret them as they consider therapeutic options-including clinical trials and targeted therapies-and discuss the prognosis of these tumors with their patients. The revised, updated 2021 WHO classification also further integrates molecular alterations in the classification of pediatric CNS tumors, but those are not covered in the current review.The 2016 revised fourth edition of the World Health Organization (WHO) classification of central nervous system (CNS) tumors incorporated molecular features with histologic grading, revolutionizing how oncologists conceptualize primary brain and spinal cord tumors as well as providing new insights into their management and prognosis. The 2021 revised fifth edition of the WHO classification further integrates molecular alterations for CNS tumor categorization, updating current understanding of the pathophysiology of many of these disease entities. Here, the authors review changes in the new classification for the most common primary adult tumors-gliomas (including astrocytomas, oligodendrogliomas, and ependymomas) and meningiomas-highlighting the key genomic alterations for each group classification to help clinicians interpret them as they consider therapeutic options-including clinical trials and targeted therapies-and discuss the prognosis of these tumors with their patients. The revised, updated 2021 WHO classification also further integrates molecular alterations in the classification of pediatric CNS tumors, but those are not covered in the current review.
Author	Gritsch, Simon Batchelor, Tracy T. Gonzalez Castro, L. Nicolas
Author_xml	– sequence: 1 givenname: Simon surname: Gritsch fullname: Gritsch, Simon organization: Harvard Medical School – sequence: 2 givenname: Tracy T. surname: Batchelor fullname: Batchelor, Tracy T. organization: Harvard Medical School – sequence: 3 givenname: L. Nicolas orcidid: 0000-0001-7699-5188 surname: Gonzalez Castro fullname: Gonzalez Castro, L. Nicolas email: lgonzalez-castro@dfci.harvard.edu organization: Harvard Medical School
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Keywords	glioma 2021 World Health Organization (WHO) central nervous system (CNS) tumor classification glioblastoma meningiomas isocitrate dehydrogenase (IDH)-mutant gliomas
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Snippet	The 2016 revised fourth edition of the World Health Organization (WHO) classification of central nervous system (CNS) tumors incorporated molecular features...
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SubjectTerms	2021 World Health Organization (WHO) central nervous system (CNS) tumor classification Adult Astrocytoma Brain cancer Brain Neoplasms - diagnosis Brain Neoplasms - therapy Brain tumors Central nervous system Central Nervous System - pathology Central Nervous System Neoplasms - diagnosis Central Nervous System Neoplasms - genetics Central Nervous System Neoplasms - therapy Child Classification Clinical trials glioblastoma Glioma Glioma - pathology Humans isocitrate dehydrogenase (IDH)‐mutant gliomas Isocitrate Dehydrogenase - genetics Medical diagnosis Medical prognosis meningiomas Mutation Nervous system Oncology Pathophysiology Pediatrics Prognosis Spinal cord Tumors World Health Organization
Title	Diagnostic, therapeutic, and prognostic implications of the 2021 World Health Organization classification of tumors of the central nervous system
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