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WHO 2021 – Oligodendroglioma Molecular Classification — SCE Neurology MCQ

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HardNeuro-oncologyWHO 2021 – Oligodendroglioma Molecular ClassificationSCE Neurology

A 34-year-old has a second unresectable recurrence of a histologically confirmed ganglioglioma after surgery and radiotherapy. Systemic treatment is being considered. Which molecular result is the most actionable and characteristic target to seek?

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Correct answer: E — Test for BRAF V600E before selecting BRAF/MEK-directed treatment

Explanation lettering: C = shown as A · E = shown as B · D = shown as C · B = shown as D · A = shown as E

A is correct: recurrent ganglioglioma commonly harbours BRAF V600E, and EANO supports testing when further treatment is required because BRAF/MEK-directed therapy can be considered. B pairs a more typical pilocytic-astrocytoma alteration with the wrong drug class. C, D and E each mismatch the molecular marker, tumour biology and proposed targeted therapy. The point is not indiscriminate sequencing but selecting a biologically credible actionable alteration.

Reference: EANO guideline on molecular testing for targeted therapy selection: https://pmc.ncbi.nlm.nih.gov/articles/PMC10158123/