The medical necessity of advanced molecular testing in the diagnosis and treatment of brain tumor patients
Year: 2019
Type: article
Abstract: Accurate pathologic diagnoses and molecularly informed treatment decisions for a wide variety of cancers depend on robust clinical molecular testing that uses genomic, epigenomic, and transcriptomic-based tools. Nowhere is this more essential than in the workup of brain tumors, as emphasized by the incorporation of molecular criteria into the 2016 World Health Organization classification of central nervous system tumors and the updated official guidelines of the National Comprehensive Cancer Network. Despite the medical necessity of molecular testing in brain tumors, access to and utilization of molecular diagnostics is still highly variable across institutions, and a lack of reimbursement for such testing remains a significant obstacle. The objectives of this review are (i) to identify barriers to adoption of molecular testing in brain tumors, (ii) to describe the current molecular tools recommended for the clinical evaluation of brain tumors, and (iii) to summarize how molecular data are interpreted to guide clinical care, so as to improve understanding and justification for their coverage in the routine workup of adult and pediatric brain tumor cases.
Source: Neuro-Oncology
Authors: Craig Horbinski, Keith L Ligon, Priscilla Brastianos, Jason T Huse, Monica Venere, Susan Chang, Jan Buckner, Timothy Cloughesy, Robert B Jenkins, Caterina Giannini, Roger Stupp, L Burt Nabors, Patrick Y Wen, Kenneth J Aldape, Rimas V Lukas, Evanthia Galanis, Charles G Eberhart, Daniel J Brat, Jann N Sarkaria
Institutions: Northwestern University, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Massachusetts General Hospital, The University of Texas MD Anderson Cancer Center, The Ohio State University, University of California, San Francisco, Mayo Clinic, Mayo Clinic Comprehensive Cancer Center (Minnesota), University of California, Los Angeles, University of Alabama at Birmingham, Harvard University, Center for Neuro-Oncology, Dana-Farber Brigham Cancer Center, National Cancer Institute, Center for Cancer Research, Johns Hopkins University, Johns Hopkins Hospital
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2954265132