PS2 - 195 Integrating Molecular Workings into the World Health Organization (WHO) Classification of Tumours of the Central Nervous System: A Survey from the Neuro-Oncology Community

Abstract

Tumours of the central nervous system are currently classified based on the 2007 WHO Classification of Tumours, which uses histological features to classify and grade these heterogeneous tumors. With recent advances in the development of clinically relevant molecular signatures, there is an interest to incorporate appropriate molecular markers in to the classification. The views of the neuro-oncology community on such changes would be informative for advising this process. METHODS A survey with 8 questions regarding molecular markers in tumor classification was sent to an email list of Society of Neuro-Oncology members and attendees of prior meetings (n=5065). There were 403 respondents. Analysis was performed using whole group response and based on self-reported sub-specialty. RESULTS Survey results among all respondents show support for incorporating our molecular knowledge of brain tumors into the WHO classification (>80%). As one example, 96% of respondents responded that the integration of 1p/19q co-deletion into the molecular classification of oligodendroglioma was “very” or “critically” important for the management of grade III gliomas. While 30% of all respondents believe that IDH mutation status should affect overall management of GBM. Interestingly, there was some variability among sub-specialties for certain aspects, and as one example neuropathologists were slightly more inclined to disagree that molecular markers should be included in the WHO classification (25% for neuropathologists versus 13% overall). CONCLUSION Based on a survey provided to the neuro-oncology community, we report strong support for the integration of molecular markers into the WHO classification of brain tumors, as well as for using an integrated “layered” diagnostic format.