Bridging pediatric and adult neuro-oncology: Insights into adolescents and young adults (AYA) central nervous system tumors
4 affiliations
- 1Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada; Corresponding author.
- 2Department of Pediatric Oncology, Dana-Farber / Boston Children's Cancer and Blood Disorders Center, USA
- 3Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada; Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- 4Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
Abstract
Adolescents and young adults (AYA) with central nervous system (CNS) tumors represent a distinct and historically underrecognized population that spans the traditional pediatric–adult oncology divide, with unique biological, clinical, and survivorship considerations. The central nervous system (CNS) tumor spectrum in this age band is thus broad: pediatric-type entities driven by MAPK-pathway alterations, adult-type IDH- and H3-mutant gliomas, embryonal tumors, ependymomas, and intracranial germ cell tumors all appear, and prognosis and treatment are increasingly determined by molecular subtype rather than chronologic age. Integrated workflows combining neuroimaging, histopathology, and molecular profiling now anchor diagnosis and risk stratification. Treatment strategy — surgery, radiotherapy, systemic and targeted agents, and emerging immunotherapies — must balance efficacy against the cumulative late effects that come with it: neurocognitive change, endocrinopathy, vasculopathy, fertility loss, psychosocial disruption, and gaps in transition of care. Germline predisposition syndromes contribute meaningfully to disease biology and have implications for treatment, surveillance, and family screening. This review synthesizes the current evidence across diagnosis, treatment, survivorship, and predisposition, and argues for the consolidation of AYA neuro-oncology as a distinct discipline supported by dedicated trial access and survivorship infrastructure.
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BibTeX
@article{hennawy2026bridging,
title = {{Bridging pediatric and adult neuro-oncology: Insights into adolescents and young adults (AYA) central nervous system tumors}},
author = {Mirna Hennawy and Anna Mullins and Julie Bennett and Kee Kiat Yeo and Mary Jane Lim-Fat},
journal = {Neurotherapeutics},
year = {2026},
month = oct,
doi = {10.1016/j.neurot.2026.e01061},
url = {https://doi.org/10.1016/j.neurot.2026.e01061},
note = {CC BY},
}
RIS
TY - JOUR
TI - Bridging pediatric and adult neuro-oncology: Insights into adolescents and young adults (AYA) central nervous system tumors
AU - Mirna Hennawy
AU - Anna Mullins
AU - Julie Bennett
AU - Kee Kiat Yeo
AU - Mary Jane Lim-Fat
PY - 2026
DA - 2026/10/24
JO - Neurotherapeutics
DO - 10.1016/j.neurot.2026.e01061
UR - https://doi.org/10.1016/j.neurot.2026.e01061
AB - Adolescents and young adults (AYA) with central nervous system (CNS) tumors represent a distinct and historically underrecognized population that spans the traditional pediatric–adult oncology divide, with unique biological, clinical, and survivorship considerations. The central nervous system (CNS) tumor spectrum in this age band is thus broad: pediatric-type entities driven by MAPK-pathway alterations, adult-type IDH- and H3-mutant gliomas, embryonal tumors, ependymomas, and intracranial germ cell tumors all appear, and prognosis and treatment are increasingly determined by molecular subtype rather than chronologic age. Integrated workflows combining neuroimaging, histopathology, and molecular profiling now anchor diagnosis and risk stratification. Treatment strategy — surgery, radiotherapy, systemic and targeted agents, and emerging immunotherapies — must balance efficacy against the cumulative late effects that come with it: neurocognitive change, endocrinopathy, vasculopathy, fertility loss, psychosocial disruption, and gaps in transition of care. Germline predisposition syndromes contribute meaningfully to disease biology and have implications for treatment, surveillance, and family screening. This review synthesizes the current evidence across diagnosis, treatment, survivorship, and predisposition, and argues for the consolidation of AYA neuro-oncology as a distinct discipline supported by dedicated trial access and survivorship infrastructure.
SN - 1878-7479
SN - 1933-7213
ER -