Major features of the 2021 WHO Classification of Tumors of the Central Nervous System: clinician’s view

Abstract

Advances in the understanding of the molecular biology of central nervous system (CNS) tumors have prompted a new WHO classification of brain and spinal cord tumors in 2021 and integration it in routine clinical practice. Nowadays accurate diagnosis verification consists not only of the histological tumor type, but also includes its molecular-genetic characteristics. Differences in the genetic features of a tumor, even within the same histological type, will determine differences in the prognosis of the disease, and in the tactics of anticancer therapy. The introduced changes necessitate a comprehensive diagnosis of CNS tumors, thereby placing the responsibility for formulating the final diagnosis not only on pathologists. New approaches to classification make it possible to personalize anticancer treatment, as well as including new methods of targeted and immunotherapy, which today seems to be a key aspect of improving the survival of this category of patients.