Background: The Italian Association of Neuro-Oncology (AINO) and the Italian Society of Neurosurgery (SINch) promoted a national survey to explore how the 2021 WHO molecular diagnostic criteria for gliomas have been implemented into clinical practice. Methods: A survey containing 38-item multiple-choice questions was sent to members of the AINO and SINch from January 2022 to March 2022. Results: We collected 152 answers. Participants from non-academic vs academic hospitals were 78 (51.3%) and 74 (48.7%). Assessment of IDH mutations and 1p/19q codeletion was reported by 140 (92.1%) and 88 (57.9%) responders, respectively. MGMTp methylation, either at diagnosis or at second surgery, was reported by 110 (72.4%) and 82 (53.9%) responders, respectively. CDKN2A/B homozygous deletion in IDH-mutant astrocytomas was investigated according to 53 (34.9%) responders. Assessment of either EGFR amplification or pTERT mutation or +7-10 chromosome changes in IDH-wild type astrocytomas was reported by 76 (50.0%), 43 (28.3%), and 16 (10.5%) responders, respectively. Academic vs non-academic hospitals had a higher availability of molecular markers, including CDKN2A/B deletion (34/70, 48.6% vs 19/82, 23.2%, P=0.001), MGMTp at second surgery (48/69, 69.6% vs 34/72, 47.2%, P=0.008), EGFR/pTERT/+7-10 (46/70, 65.7% vs 32/77, 41.6%, P=0.003), BRAF mutation (14/70, 20.0% vs 4/82, 4.9%, P=0.002), NTRK fusion (14/70, 20.0% vs 2/81, 2.5%, P<0.001). Conclusions: The availability of molecular markers for gliomas is widespread among Italian centers. The implementation of the molecular criteria for diagnostic and prognostic purposes in gliomas according to WHO 2021 Classification needs to be improved. Moreover, a critical issue for the future will be the search for rare actionable mutations, which is continuously evolving, in light of the use of targeted therapy.
Real-life implementation of molecular criteria for diagnosing gliomas according to 2021 WHO Classification: a national survey from the Italian Association of Neuro-Oncology and Society of Neurosurgery / Pellerino, Alessia; Somma, Teresa; Bruno, Francesco; D'Alessandris, Quintino G.; Internò, Valeria; Polo, Valentina; Aiudi, Denis; Spena, Giannantonio; Ius, Tamara; Esposito, Vincenzo; Silvani, Antonio; Rudà, Roberta. - In: JOURNAL OF NEUROSURGICAL SCIENCES. - ISSN 1827-1855. - (2025). [10.23736/s0390-5616.25.06457-4]
Real-life implementation of molecular criteria for diagnosing gliomas according to 2021 WHO Classification: a national survey from the Italian Association of Neuro-Oncology and Society of Neurosurgery
SOMMA, Teresa;
2025
Abstract
Background: The Italian Association of Neuro-Oncology (AINO) and the Italian Society of Neurosurgery (SINch) promoted a national survey to explore how the 2021 WHO molecular diagnostic criteria for gliomas have been implemented into clinical practice. Methods: A survey containing 38-item multiple-choice questions was sent to members of the AINO and SINch from January 2022 to March 2022. Results: We collected 152 answers. Participants from non-academic vs academic hospitals were 78 (51.3%) and 74 (48.7%). Assessment of IDH mutations and 1p/19q codeletion was reported by 140 (92.1%) and 88 (57.9%) responders, respectively. MGMTp methylation, either at diagnosis or at second surgery, was reported by 110 (72.4%) and 82 (53.9%) responders, respectively. CDKN2A/B homozygous deletion in IDH-mutant astrocytomas was investigated according to 53 (34.9%) responders. Assessment of either EGFR amplification or pTERT mutation or +7-10 chromosome changes in IDH-wild type astrocytomas was reported by 76 (50.0%), 43 (28.3%), and 16 (10.5%) responders, respectively. Academic vs non-academic hospitals had a higher availability of molecular markers, including CDKN2A/B deletion (34/70, 48.6% vs 19/82, 23.2%, P=0.001), MGMTp at second surgery (48/69, 69.6% vs 34/72, 47.2%, P=0.008), EGFR/pTERT/+7-10 (46/70, 65.7% vs 32/77, 41.6%, P=0.003), BRAF mutation (14/70, 20.0% vs 4/82, 4.9%, P=0.002), NTRK fusion (14/70, 20.0% vs 2/81, 2.5%, P<0.001). Conclusions: The availability of molecular markers for gliomas is widespread among Italian centers. The implementation of the molecular criteria for diagnostic and prognostic purposes in gliomas according to WHO 2021 Classification needs to be improved. Moreover, a critical issue for the future will be the search for rare actionable mutations, which is continuously evolving, in light of the use of targeted therapy.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
