The molecular profile of gliomas in adolescents and young adults

Adolescents and young adults (AYAs), defined as individuals aged 15-39, represent a distinct and underrepresented population in glioma research and clinical care. Gliomas are the most common central nervous system (CNS) tumors in this population and span both pediatric and adult molecular subtypes, making diagnosis and treatment particularly complex. While the 2021 WHO classification of CNS tumors underscores key molecular differences across age groups, there remain limited standardized, age-specific guidelines for AYA patients. Molecular profiling is especially critical in this demographic, as more than 80% of AYA gliomas harbor potentially targetable alterations, including IDH mutations and RAS/MAPK pathway abnormalities. Optimizing outcomes for AYA patients requires multidisciplinary collaboration across pediatric and adult specialties. Currently, low clinical trial participation and fragmented care contribute to significant disparities in treatment and outcomes. To overcome these challenges, there is an urgent need for dedicated AYA treatment frameworks, expanded clinical trial eligibility, and the routine integration of comprehensive molecular diagnostics. These efforts are essential to closing the care gap and enhancing both survival and quality of life for this vulnerable population.