A framework for standardised tissue sampling and processing during resection of diffuse intracranial glioma: joint recommendations from four RANO groups.

Malte Mohme, Joerg-Christian Tonn, Mitchel S Berger, Susan M Chang, Michael A Vogelbaum, Michael Weller, Martin van den Bent, Minesh P Mehta, Raymond Y Huang, Nathalie L Albert, Louisa von Baumgarten, Philipp Karschnia, Patrick N Harter, Oliver Schnell, Jason T Huse, Michelle M Kim, Norbert Galldiks, Benjamin M Ellingson, Emilie Le Rhun, Guido Reifenberger, Marion Smits

Journal: The Lancet. Oncology 2023;24(11):e438-e450

PMID: 37922934

Abstract

Surgical resection represents the standard of care for people with newly diagnosed diffuse gliomas, and the neuropathological and molecular profile of the resected tissue guides clinical management and forms the basis for research. The Response Assessment in Neuro-Oncology (RANO) consortium is an international, multidisciplinary effort that aims to standardise research practice in neuro-oncology. These recommendations represent a multidisciplinary consensus from the four RANO groups: RANO resect, RANO recurrent glioblastoma, RANO radiotherapy, and RANO/PET for a standardised workflow to achieve a representative tumour evaluation in a disease characterised by intratumoural heterogeneity, including recommendations on which tumour regions should be surgically sampled, how to define those regions on the basis of preoperative imaging, and the optimal sample volume. Practical recommendations for tissue sampling are given for people with low-grade and high-grade gliomas, as well as for people with newly diagnosed and recurrent disease. Sampling of liquid biopsies is also addressed. A standardised workflow for subsequent handling of the resected tissue is proposed to avoid information loss due to decreasing tissue quality or insufficient clinical information. The recommendations offer a framework for prospective biobanking studies.

Copyright © 2023 Elsevier Ltd. All rights reserved.

Address: Department of Neurosurgery, Ludwig-Maximilians-University of Munich, Munich, Germany; German Cancer Consortium, Partner Site Munich, Munich, Germany.; Department of Neuroradiology and Nuclear Medicine, Erasmus MC Cancer Institute, Rotterdam, Netherlands.; Institute of Neuropathology, Heinrich Heine University Medical Faculty and University Hospital Düsseldorf, Düsseldorf, Germany.; Department of Neurosurgery, University Hospital of Zurich and University of Zurich, Zurich, Switzerland; Department of Neurology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland.; UCLA Brain Tumor Imaging Laboratory, Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.; Department of Neurology, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany; Research Center Juelich, Institute of Neuroscience and Medicine, Juelich, Germany.; Department of Radiation Oncology, University of Michigan Hospital, Ann Arbor, MI, USA.; Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.; Department of Neurosurgery, University of Freiburg, Freiburg, Germany.; German Cancer Consortium, Partner Site Munich, Munich, Germany; Center for Neuropathology and Prion Research, Faculty of Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.; Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.; Division of Neuroradiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.; Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA.; Department of Neurology, Erasmus MC Cancer Institute, Rotterdam, Netherlands.; Department of Neurology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland.; Department of NeuroOncology, Moffitt Cancer Center, Tampa, FL, USA.; Department of Neurosurgery and Division of Neuro-Oncology, University of California, San Francisco, CA, USA.; Department of Neurosurgery, Ludwig-Maximilians-University of Munich, Munich, Germany; German Cancer Consortium, Partner Site Munich, Munich, Germany. Electronic address: [email protected].
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