Advances in the molecular classification of pediatric brain tumors: a guide to the galaxy

J Pathol. 2020 Jul;251(3):249-261. doi: 10.1002/path.5457. Epub 2020 Jun 10.

Abstract

Central nervous system (CNS) tumors are the most common solid tumor in pediatrics, accounting for approximately 25% of all childhood cancers, and the second most common pediatric malignancy after leukemia. CNS tumors can be associated with significant morbidity, even those classified as low grade. Mortality from CNS tumors is disproportionately high compared to other childhood malignancies, although surgery, radiation, and chemotherapy have improved outcomes in these patients over the last few decades. Current therapeutic strategies lead to a high risk of side effects, especially in young children. Pediatric brain tumor survivors have unique sequelae compared to age-matched patients who survived other malignancies. They are at greater risk of significant impairment in cognitive, neurological, endocrine, social, and emotional domains, depending on the location and type of the CNS tumor. Next-generation genomics have shed light on the broad molecular heterogeneity of pediatric brain tumors and have identified important genes and signaling pathways that serve to drive tumor proliferation. This insight has impacted the research field by providing potential therapeutic targets for these diseases. In this review, we highlight recent progress in understanding the molecular basis of common pediatric brain tumors, specifically low-grade glioma, high-grade glioma, ependymoma, embryonal tumors, and atypical teratoid/rhabdoid tumor (ATRT). © 2020 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Keywords: atypical teratoid/rhabdoid tumor (ATRT); ependymoma; high-grade glioma; low-grade glioma; medulloblastoma; primitive neuro-ectodermal tumor (PNET).

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Age of Onset
  • Biomarkers, Tumor / genetics*
  • Brain Neoplasms / classification
  • Brain Neoplasms / genetics*
  • Brain Neoplasms / mortality
  • Brain Neoplasms / pathology
  • Cerebellar Neoplasms / classification
  • Cerebellar Neoplasms / genetics*
  • Cerebellar Neoplasms / mortality
  • Cerebellar Neoplasms / pathology
  • Ependymoma / classification
  • Ependymoma / genetics*
  • Ependymoma / mortality
  • Ependymoma / pathology
  • Genetic Predisposition to Disease
  • Glioma / classification
  • Glioma / genetics*
  • Glioma / mortality
  • Glioma / pathology
  • Humans
  • Medulloblastoma / classification
  • Medulloblastoma / genetics*
  • Medulloblastoma / mortality
  • Medulloblastoma / pathology
  • Neoplasm Grading
  • Phenotype
  • Rhabdoid Tumor / classification
  • Rhabdoid Tumor / genetics*
  • Rhabdoid Tumor / mortality
  • Rhabdoid Tumor / pathology
  • Teratoma / classification
  • Teratoma / genetics*
  • Teratoma / mortality
  • Teratoma / pathology

Substances

  • Biomarkers, Tumor

Supplementary concepts

  • Teratoid Tumor, Atypical

Grants and funding