Neurooncology: 2026 update

Abstract

The present collection of studies highlights major conceptual and translational advances in contemporary neurooncology related to the field of neuropathology. Central themes include the increasing recognition of neuron-tumor interactions, immune microenvironment remodeling, vascular heterogeneity, and epigenetic plasticity as key drivers of brain tumor progression and therapeutic resistance. Glioblastoma emerges as a highly dynamic and synaptically integrated disease entity, while melanoma brain metastases demonstrate profound microglial reprogramming with direct implications for immunotherapy. Novel molecular and spatial profiling approaches further reveal distinct vascular and immune landscapes across gliomas and brain metastases as well as lineage-dependent developmental programs in medulloblastoma. In parallel, rapid advances in artificial intelligence, nanopore sequencing, and real-time molecular diagnostics are reshaping neuropathological workflows and intraoperative decision-making. Proteomic and multi-omics analyses additionally uncover clinically relevant immune-hot glioma subtypes associated with adverse prognosis and spatial immune remodeling. Together, these studies underscore the increasing convergence of molecular neurobiology, immunology, epigenetics, and computational pathology in modern neurooncology and highlight emerging opportunities for precision diagnostics and targeted therapeutic intervention.