Precision diagnosis and therapy for pediatric central nervous system tumors: consensus from the Brazilian Society of Pediatric Oncology (SOBOPE).

Abstract

Precision medicine has reshaped the classification and management of pediatric central nervous system tumors, enabling more accurate diagnoses and targeted therapies. However, access to molecular diagnostics and precision treatments remains uneven in many low- and middle-income countries, including Brazil. To address this gap, the Brazilian Society of Pediatric Oncology (SOBOPE) convened a national expert panel to develop consensus recommendations adapted to the Brazilian healthcare context. Using a structured literature overview and a modified Delphi process involving pediatric oncologists, neuropathologists, and laboratory medicine specialists, the panel proposed a tiered molecular testing strategy prioritizing essential and actionable biomarkers. Recommendations were tailored to both public and private healthcare settings and aligned with therapeutic guidance when targeted options are feasible. This consensus provides a practical framework to standardize molecular testing, support clinical decision-making, and promote equitable implementation of precision medicine in pediatric neuro-oncology in Brazil.