Publications 

    1. Bennett J, Levine AB, Nobre L, Negm L, Chung J, Fang K, et al. A population-based analysis of the molecular landscape of glioma in adolescents and young adults reveals insights into gliomagenesis. Nature Cancer. 2025;6(6):1102–1119. doi:10.1038/s43018-025-00962-x

    Researchers analyzed more than 1,400 brain tumor samples from adolescents and young adults (AYAs) in Toronto to better understand how gliomas differ across age groups. They found that about one-third of AYA gliomas carry “pediatric-type” genetic changes, which are generally associated with better outcomes than “adult-type” tumors. Alterations in the RAS–MAPK pathway, including BRAF and FGFR mutations, were especially common. The study showed that age influences tumor biology, growth patterns, treatment response, and the risk of malignant transformation, highlighting the need for age-specific testing and treatment strategies for AYA gliomas.

    1. Gascon B, Gauvreau C, Yang A, Bennett J, Nobre L, Tabori U, et al. Cost-effectiveness of dabrafenib plus trametinib versus standard chemotherapy in BRAFV600E-mutant pediatric low-grade glioma. JCO Oncology Practice. 2026. Advance online publication. doi:10.1200/OP-25-01263

    Researchers compared the long-term value of combining dabrafenib and trametinib with standard chemotherapy for children with BRAFV600E-mutant pediatric low-grade glioma. The targeted therapy improved quality-adjusted survival by about 2.2 years but added more than $550,000 CAD in costs. At current pricing, indefinite treatment was not considered cost-effective in the Canadian health care system. However, shorter treatment durations, such as two years, appeared much more affordable and potentially cost-effective.

    1. Lim-Fat MJ, Macdonald M, Lapointe S, Climans SA, Cacciotti C, Chahal M, et al. Molecular testing for adolescent and young adult central nervous system tumors: a Canadian guideline. Frontiers in Oncology. 2022;12:960509. doi:10.3389/fonc.2022.960509

    The 2021 World Health Organization classification of CNS tumors emphasizes important differences between pediatric and adult brain tumors. Adolescents and young adults (AYAs) can develop tumors from both groups and often require specialized care across pediatric and adult healthcare settings. To address the lack of consistent testing guidelines for this population, the Canadian AYA Neuro-Oncology Consortium developed a practical framework for molecular testing in AYA brain tumor patients. The goal is to improve diagnosis, prognosis, and care across Canada.

    1. Erker C, Vanan MI, Larouche V, Nobre L, Cacciotti C, Vairy S, et al. Canadian Consensus for Treatment of BRAF V600E Mutated Pediatric and AYA Gliomas. PMID: 39057171; PMCID: PMC11276207.

    A Canadian panel of neuro-oncology experts developed consensus guidelines for treating children and adolescents/young adults with BRAF V600E-mutated gliomas. Since clinical trials have not yet answered key questions about when to start, stop, and taper treatment, 26 Canadian specialists collaborated to create two treatment algorithms: one for initiating therapy and one for discontinuing it. The group recommends that most patients with BRAF V600E gliomas receive BRAF inhibitors, with or without MEK inhibitors, as an upfront treatment approach. When treatment is stopped, a gradual taper is recommended in certain cases.

    Publications

    1. A population-based analysis of the molecular landscape of glioma in adolescents and young adults reveals insights into gliomagenesis

    Gliomas are the most common type of brain tumor and a major cause of cancer-related deaths among adolescents and young adults (AYAs, ages 15–39). While it’s known that children and older adults gliomas show different genetic mutations, this study fills a major knowledge gap by examining how these differences appear in AYAs. Researchers analyzed more than 1,400 brain tumor samples from young people in Toronto, combining clinical data with detailed genetic testing. They found that about one-third of AYA gliomas carry “pediatric-type” genetic alterations, which tend to lead to better outcomes than “adult-type” tumors. Tumors driven by changes in the RAS–MAPK pathway (including BRAF and FGFR mutations) were especially common and behaved differently across ages— specifically with low-grade RAS/MAPK altered tumors, which showed slower tumor growth. The study also uncovered how certain mutations, like IDH, evolve over time and how age influences tumor biology, treatment response, and risk of malignant transformation. Overall, these findings reveal that gliomas in AYAs are biologically distinct from children and older adult gliomas, emphasizing the need for age-tailored diagnostic testing and targeted treatments to improve survival while avoiding unnecessary therapy.