cIMPACT-NOW: a practical summary of diagnostic points from Round 1 updates

Brain Pathol. 2019 Jul;29(4):469-472. doi: 10.1111/bpa.12732. Epub 2019 May 22.


cIMPACT-NOW (the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy) was established to provide a forum to evaluate and recommend proposed changes to future CNS tumor classifications. From 2016 to 2019 (Round 1), cIMPACT published four updates. Update 1 clarified the use of the term NOS (Not Otherwise Specified) and proposed use of the additional term NEC (Not Elsewhere Classified). Update 2 issued clarifications regarding two diagnoses: Diffuse Midline Glioma, H3 K27M-mutant and Diffuse Astrocytoma/Anaplastic Astrocytoma, IDH-mutant. Update 3 proposed molecular criteria that could be used in the setting of an IDH-wildtype diffuse or anaplastic astrocytic glioma without histological features of glioblastoma to infer that the tumor would behave similarly to a grade IV glioblastoma. Update 4 suggested that, in children and young adults, subtypes of IDH-wildtype/H3-wildtype diffuse gliomas may have distinct clinical features in the setting of a BRAFV600E mutation, FGFR1 alteration, other MAPK pathway alteration, or a MYB or MYBL1 rearrangement. The practical diagnostic relevance of these cIMPACT proposals is highlighted in this summary.

Publication types

  • Congress

MeSH terms

  • Brain Neoplasms / classification*
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / pathology
  • Central Nervous System Neoplasms / classification*
  • Central Nervous System Neoplasms / diagnosis
  • Central Nervous System Neoplasms / pathology
  • Humans
  • Neuropathology / classification*