胶质瘤、胶质神经元和神经元肿瘤成年患者的标准治疗包括手术、放疗和化疗的组合。对于许多系统性癌症，靶向治疗是标准治疗的主要部分，然而，大多数系统性癌症治疗靶点的预测意义在中枢神经系统（CNS）肿瘤中尚未明确。 2023 年，EANO 指南委员会提出了合理测试分子靶点以进行靶向治疗的基于证据的建议。从所有审查的目标中，只有 BRAF V600E 突变测试被证明具有临床益处；尽管监管部门批准了针对成人脑肿瘤患者的 NTRK 基因融合和高肿瘤突变负担（TMB）的肿瘤不可知治疗，但对患者的临床益处的证据仍然有限。本指南采用模块化结构，允许定期更新各个部分并添加新部分。当前版本（更新 1）对 PTEN、H3F3A、MTAP、RET 和 IDH 测试的基本原理进行了回顾，并更新了有关 TMB 高和错配修复缺陷的文本。它还概述了用于突变和融合检测的常规下一代测序的治疗效果。该版本随附的补充包含对所有目标的深入审查，而在主手稿中则提出了修订后的目标和新目标的最终建议。我们将定期更新。© 作者 2024。由牛津大学出版社代表神经肿瘤学会出版。版权所有。如需商业重复使用，请联系 reprints@oup.com 获取转载和转载的翻译权。所有其他权限都可以通过我们网站文章页面上的权限链接通过我们的 RightsLink 服务获得 - 如需了解更多信息，请联系journals.permissions@oup.com。

The standard of care for adult patients with gliomas, glioneuronal and neuronal tumors consists of combinations of surgery, radiotherapy, and chemotherapy. For many systemic cancers, targeted treatments are a major part of the standard treatment, however, the predictive significance of most of the targets for treatment in systemic cancer are less well established in central nervous system (CNS) tumors . In 2023 the EANO Guideline Committee presented evidence based recommendations for rational testing of molecular targets for targeted treatments. From all targets reviewed, only testing for BRAF V600E mutations was of proven clinical benefit; despite regulatory approvals for tumor agnostic treatment of NTRK gene fusions and high Tumor Mutational Burden (TMB) for patients with adult brain tumors, the evidence of clinical benefit for patients was still limited . This guideline has a modular structure, allowing regular updating of individual sections and adding new ones. The present version (Update 1) presents a review of the rationale of testing for PTEN, H3F3A, MTAP, RET and IDH, and presents an update of the text on TMB high and mismatch repair deficiency. It also presents an overview of therapeutic yield of routine next generation sequencing for mutations and fusion detection. The supplement accompanying this version contains the in depth review of all targets, whereas in the main manuscript the final recommendations of the revised and new targets are presented. Updates will be made on a regular basis.© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.