Something Old and Something New About Molecular Diagnostics in Gliomas

Progress in understanding the molecular biology of neoplasms has been driven by remarkable improvements in molecular biology techniques, creating a rapidly moving field in which even subspecialists struggle to keep abreast. Nowhere is this more clearly demonstrated than in neuro-oncology, wherein molecular diagnostics can wring more clinically useful information out of small biopsies than ever. The biologic and practical aspects of 4 key molecular biomarkers in gliomas are discussed, including 2 that have been known for some time (1p/19q codeletion and epidermal growth factor receptor [EGFR] amplification) as well as 2 whose relevance was discovered via advanced whole-genome assays (IDH1/2 mutations and BRAF alterations).