Cancer types · Other solid tumours
Brain & Central Nervous System Tumours
Brain and central nervous system tumours include primary tumours, such as gliomas and meningiomas, and secondary tumours that have spread from cancer elsewhere.
For primary brain tumours, molecular features are now part of the diagnosis itself under the current WHO classification. Two tumours that look similar under the microscope can be classified differently because of their molecular results.
Clinical and molecular questions that often arise
- Does the diagnosis integrate both histology and molecular results?
- What are the IDH, 1p/19q and MGMT results for a glioma?
- For children and young adults, are BRAF or H3 alterations relevant?
- For brain metastases, what does the primary cancer’s molecular profile show?
Information that may be part of an individual assessment
- MRI with contrast.
- Surgical biopsy or resection with neuropathology.
- Molecular testing integrated into the diagnosis.
- For metastases, information from the primary cancer.
Which investigations are appropriate is decided by the treating team for each person.
Molecular profiling and biomarker interpretation
Depending on the setting, molecular and biomarker questions in brain & central nervous system tumours may involve:
- IDH1 and IDH2 mutations
- 1p/19q codeletion
- MGMT promoter methylation
- H3 K27M alteration
- BRAF V600E and BRAF fusions
- CDKN2A/B deletion, TERT promoter and EGFR amplification
Biomarkers, panels and available tests vary by subtype, disease setting, assay and guideline version. A detected alteration is not automatically actionable.
How KPCIRC pathways may apply
POAS
POAS may help organise a neuro-oncology molecular report, especially where rare alterations or trial questions arise.
Molecular Tumour Board
MTB review is often valuable because neurosurgery, neuropathology, radiation oncology and medical oncology perspectives need to come together.
Second opinion and progression review
A second opinion may help clarify an integrated diagnosis or the proposed plan. Progression review may help distinguish questions about treatment effects from disease change, which can be difficult on imaging.
Hereditary risk and screening
Most brain tumours are not inherited. Rare syndromes such as Li-Fraumeni, neurofibromatosis and constitutional mismatch-repair deficiency are associated with some brain tumours, particularly in children and young adults.
How to access the relevant pathway
Patients and families
- Talk to your treating oncologist about whether an additional review may help.
- Request a consultation and tell us which question you want answered.
- Share records only when asked, through the secure route.
Referring doctors
- Define the clinical question and the pathway: POAS, MTB, second opinion or progression review.
- Start a case enquiry without patient identifiers.
- Scope, fees and timing are confirmed before any review proceeds.
Questions and limitations
Why does my diagnosis mention genes?
Because the current classification of brain tumours uses molecular results as part of the diagnosis, not only as extra information.
Can changes on an MRI after treatment be misleading?
Yes. Treatment can cause changes that resemble tumour growth. Interpretation needs specialist review in context.
Does this page apply to my situation?
This page is educational. It explains common questions but cannot account for individual circumstances. Your treating clinician is best placed to interpret your reports and plan your care.
Educational content reviewed against the KPCIRC service scope. It is not a diagnosis, a treatment recommendation or a statement that a specialist or service is available for this cancer type.