GENE-04. ESTABLISHING A MOLECULAR PROFILING SERVICE FOR CHILDREN’S CENTRAL NERVOUS SYSTEM TUMORS IN AUSTRALASIA – THE AUSTRALIAN AND NEW ZEALAND CHILDREN’S HAEMATOLOGY AND ONCOLOGY GROUP (ANZCHOG) AIM BRAIN PROJECT

Pediatric neuro-oncology has undergone an exciting and dramatic transformation during the past decade. Molecular analyses have identified subtypes of central nervous system (CNS) tumors not distinguishable using traditional histopathological techniques culminating in the integration of molecular and histologic parameters in the 2016 WHO classification. Analysis of thousands of childhood CNS tumor samples by our collaborators at the German Cancer Research Centre and others has revealed each tumour entity comprises multiple sub-types, each with different survival outcomes and disease characteristics. This led to the establishment of the Molecular Neuropathology 2 (MNP2.0) study, which undertakes methylation profiling of CNS tumors to identify these sub-types and is currently recruiting Australasian participants. The Access to Innovative Molecular Profiling for Pediatric Brain Cancers (AIM BRAIN PROject) will provide a local molecular tumor profiling service for pediatric CNS tumors in Australia and New Zealand. To demonstrate clinical specificity and sensitivity, methylation array profiling results generated locally will be cross-validated with those from MNP2.0. The study aims to recruit up to 400 participants from Australia and New Zealand over four years. Recruitment began in November 2017 and to date 47 patients have been enrolled. Of the 17 patients co-enrolled on both AIM BRAIN and MNP2.0 trials, 16 (94%) have concordant results. 30/35 (86%) of reported AIM BRAIN cases have profiling consistent with their histopathological diagnosis, three cases were not classifiable and two cases showed disparate results. Three cases underwent Tumor Board review. The extent to which molecular profiling information impacts clinical decision-making and patient care will also be investigated during the study. Provision of a centralized and accredited molecular profiling service in the Australasian region aims to not only consolidate and streamline diagnostic testing for CNS tumors but to provide a network hub to facilitate communication and research outcomes for clinical scientists, pathologists and oncologists.