ID #179

Abstract

The spectrum of Pediatric Gliomas has been revolutionised by molecular diagnostics. Such as alterations in theBRAF.We retrospectively searched the data of molecularly sequenced gliomas diagnosed between 2023 and 2025 for BRAF alterations. Of the 35 newly diagnosed gliomas screened, 7 (20%) harboured a BRAF pathway alteration (median age 4.4 years; range 2-9 years), comprising 7% of paediatric cases. Location wise 2 were optic pathway gliomas, 2 cerebellar lesions, 2 thalamic lesions and 1 supratentorial. Six cases were low grade glioma on histology and 1 case was high grade glioma. Pilocytic astrocytoma was the most frequent pathological diagnosis in children (57.1%). A BRAF V600E mutation was seen in 4 cases (2-missense, 1 non-frameshift, 1-IHC positive only, NGS insufficient) and KIAA/BRAF rearrangements seen in 3 cases. The high-grade glioma received Radiotherapy and was loss to follow up thereafter. Low grade glioma patients underwent observation only cohort (3) and chemotherapy (3) with all alive on last follow up and no relapses. The median follows up of the cohort is 12 months (5 months to 20 months).In our small cohort, BRAF fusions were found in both in infratentorial and supratentorial locations. Our study reinforces thatmolecular profiling is indispensablein the modern management of gliomasin Low-to-Middle-Income Countries (LMICs).