What is Making News in Neuro-oncology?

Central nervous system neoplasms include diverse group of tumors with a wide spectrum of morphologies, tissues of origin, histologic subtypes and molecular abnormalities. Despite their relatively rare occurrences, these tumors can result in considerable mortality as well as morbidity. Depending on their tissue of origin, these neoplasms can be broadly divided into glial and non-glial tumors. Primary glial neoplasms constitute a major group of CNS tumors and incorporate entities like astrocytomas, oligodendrogliomas, ependymomas, and mixed gliomas. Nonglial tumors are relatively uncommon and may be derived from diverse structures like pineal gland, meninges, germ cells, hematopoietic cells, metastases etc. Gliomas are the commonest primary CNS tumor, comprising about 80% of all brain tumors. Glioblastoma multiforme, the commonest histology, is quite aggressive with a 5-year relative survival of less than 5%. The treatment options essentially include maximal safe resection of the tumor followed by concurrent chemoradiation and adjuvant chemotherapy depending on the histological features, molecular studies, quantum of residue and other risk factors. Over the last 2 decades, advances in the fields of neurosurgery, radiation delivery techniques, imaging modalities, molecular and translational research, chemotherapy and immunotherapy have made the clinical scenario more optimistic, though this is yet to be translated into significant improvement in overall survival. Despite the multimodal aggressive treatment, the prognosis of patients with high grade gliomas remains poor; with a median overall survival of about 15 months. Relapse is quite often, commonly due to the extensive spread of tumor cells into surrounding regions of the brain, difficulties in complete resection due to eloquent locations, and relative chemo/radio resistance of such tumors [1, 2].