Systematic Review of Cerebrospinal Fluid Biomarker Discovery in Neuro-Oncology: A Roadmap to Standardization and Clinical Application

Nicholas Mikolajewicz ^1,2, Patricia P Yee ³, Debarati Bhanja ⁴

¹Peter Gilgan Centre for Research and Learning, Hospital for Sick Children, Toronto, ON, Canada.
²Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada.
³Medical Scientist Training Program, Penn State College of Medicine, Hershey, PA.
⁴Department of Neurosurgery, Penn State Milton S. Hershey Medical Center, Hershey, PA.
⁵Departments of Neurology and Pediatrics, Memorial Sloan Kettering Cancer Center, Manhattan, NY.
⁶Department of Neurosurgery, Ramsay Santé, Hôpital Privé Clairval, Marseille, France.
⁷University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
⁸Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
⁹Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
¹⁰Department of Neurology, University of Zurich, Zurich, Switzerland.
¹¹Miami Cancer Institute, Baptist Health South Florida, Miami, FL.
¹²Herbert Wertheim College of Medicine, Florida International University, Miami, FL.
¹³Princess Margaret Cancer Centre, Toronto, ON, Canada.
¹⁴Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.

⁰Peter Gilgan Centre for Research and Learning, Hospital for Sick Children, Toronto, ON, Canada.

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology +

|

April 12, 2024

View abstract on PubMed

Summary

Cerebrospinal fluid (CSF) analysis offers a safer, noninvasive method for diagnosing and managing central nervous system (CNS) malignancies compared to brain biopsies. This review highlights promising CSF biomarkers and proposes reporting guidelines for improved clinical application.

Area Of Science

Neuro-oncology
Molecular Diagnostics
Biomarker Discovery

Background

Invasive brain biopsies for central nervous system (CNS) malignancies carry significant risks.
Cerebrospinal fluid (CSF) molecular profiling presents a safer, noninvasive alternative for intracranial analysis.
Current CSF biomarker research faces translational challenges and requires protocol standardization.

Purpose Of The Study

To systematically review studies on CSF molecular profiling in adult CNS malignancies.
To identify and overview promising CSF biomarkers for glioma, brain metastasis, and CNS lymphomas.
To propose CSF reporting guidelines and discuss biomarker discovery considerations.

Main Methods

Systematic review of 141 studies (Medline, SCOPUS, Biosis) from January 2000 to September 2022.
Analysis of CSF molecular profiles from adult patients with brain malignancies.
Meta-analysis of proteomic data sets to identify CNS malignancy biomarkers.

Main Results

Identified numerous promising CSF biomarkers for various CNS malignancies.
Discussed factors influencing biomarker discovery, including blood-brain barrier status and CSF sampling site.
Established a resource of identified biomarkers for the research community.

Conclusions

CSF molecular profiling is a viable and less invasive approach for CNS malignancy diagnosis and management.
Standardized CSF reporting guidelines are needed for clinical translation.
Further research into CSF biomarkers can improve patient outcomes in neuro-oncology.