Molecular Diagnostic Approaches for Diffuse Gliomas Based on Updated WHO Classification and cIMPACT-NOW Proposals

Abstract

The updated 2016 World Health Organization(WHO)classification of tumors of the central nervous system(CNS)has incorporated molecular parameters into the histopathological diagnosis of the tumor in the name of "integrated diagnosis." It has enabled more prognostically precise diagnoses of brain tumor entities; however, its practical application has also raised concerns about whether genotypes predominate over phenotypes in tumor diagnostics. In response, cIMAPCT-NOW(the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy-"Not Official WHO")was established to provide a forum for evaluating and recommending proposed changes to future CNS tumor classifications. cIMPACT has thus far published seven updates on the proposal and clarification of existing and new terms and entities. Herein, we highlight the current status of clinical application of the 2016 WHO classification and cIMPACT proposals, and the future endeavor to incorporate comprehensive genomic and epigenomic profiling of CNS tumors with the aid of artificial intelligence technology for better clinical decision-making to achieve the goal of precision medicine for each patient with brain tumors.