Satisfying your neuro-oncologist: a fast approach to routine molecular glioma diagnostics

Diffuse gliomas are the most common primary brain tumors in adults. Discrimination between astrocytic and oligodendroglial lineage differentiation has been subject to substantial intra- and interobserver variability, impairing prognostic and predictive stratification. Therefore, the 2016 WHO Classification of Tumors of the Central Nervous System introduced molecular markers, notably isocitrate dehydrogenase (IDH) mutation and loss of heterozygosity 1p/19q status, to reduce diagnostic bias.¹ Nevertheless, standardized protocols for diagnostic (eg, IDH1/2 mutation, loss of heterozygosity 1p/19q) and predictive markers (eg, O⁶-methylguanine-DNA methyltransferase [MGMT] promoter methylation) are lacking. In addition, practical implementation of routine molecular workup of these tumors may be compromised by impractically long turnaround times and economic restraints, including lack of required equipment.