MS1 TOWARD ESTABLISHMENT OF ROUTINE MOLECULAR DIAGNOSTICS FOR ADULT GLIOMAS UNDER THE NATIONAL HEALTH INSURANCE

Molecular diagnosis is now an official part of the diagnosis of brain tumors. Since WHO2016 incorporated the status of IDH mutation and 1p/19q codeletion as a part of the definition for oligodendrogliomas, astrocytomas and glioblastomas, molecular tests have become an essential part of the clinical management of adult gliomas. However, these tests are not covered by the National Health Insurance in Japan, and the cost and the limited availability of tests are prohibitive to perform molecular tests in most hospitals where brain tumor patients are treated. In 2015, the Committee for Molecular Diagnosis of Brain Tumor was established within the Japan Society for Neuro-Oncology in order to develop a standardized molecular tests for adult gliomas under the National Health Insurance. For the detection of 1p/19q codeletion, FISH is the most commonly used method. However, the widely available commercial FISH probe is located within 1p36, the regions where partial deletion often occurs in glioblastoma. This could lead to miss-judgement of 1p/19q codeletion which may result in miss-diagnosis. We have designed a novel FISH probes located in the region of 1p and 19q where partial deletions are rarely found, and are developing them as an in vitro diagnostic tests. Our ultimate aim is to establish a standardized molecular tests for adult gliomas under the National Health Insurance.