Neuro-oncology is a young and emerging discipline. An interdisciplinary mindset and concerted actions in specialized expert teams are required to meet the challenges, not only in clinical patient care but also in research activities. A close communication network between clinician scientists, medical scientists and data scientists is required to ensure that emerging data from basic, translational and clinical research can be used for improving the sometimes extremely limited and prognostically unsatisfactory treatment options. The continuously developing spectrum of tasks in neuro-oncology includes the classical fields of primary and metastatic tumors of the central nervous system and neurological complications from cancer therapies. It also includes challenges of transition of patients with a disease onset in childhood from pediatric to adult neuro-oncology. This is particularly relevant because the treatment options and the prognosis of primary brain tumors in childhood have improved tremendously. Thus, a close cooperation between pediatric and adult neuro-oncology is necessary to ensure a seamless transition. All these considerations lead to specific challenges for specialized centers of excellence to ensure an innovative, competitive and sustainable framework for modern neuro-oncology.