Oligodendroglioma, IDH-mutant and 1p/19q-codeleted-prognostic factors, standard of care and chemotherapy, and future perspectives with neoadjuvant strategy

Brain Tumor Pathol. 2024 Apr;41(2):43-49. doi: 10.1007/s10014-024-00480-1. Epub 2024 Apr 2.

Abstract

Oligodendroglioma, IDH-mutant and 1p/19q-codeleted is known for their relative chemosensitivity and indolent clinical course among diffuse gliomas of adult type. Based on the data from phase 3 clinical trials, the standard of post-surgical care for those tumors is considered to be initial chemoradiotherapy regardless of histopathological grade, particularly with PCV. However, partly due to its renewed definition in late years, prognostic factors in patients with those tumors are not well established. Moreover, the survival rate declines over 15 years, with only a 37% OS rate at 20 years for grade 3 tumors, even with the current standard of care. Given that most of this disease occurs in young or middle-aged adults, further improvements in treatment and management are necessary. Here, we discuss prognostic factors, standard of care and chemotherapy, and future perspectives with neoadjuvant strategy in those tumors.

Keywords: Chemotherapy; Neoadjuvant; Nimustine; PAV; Staged resection.

Publication types

  • Review

MeSH terms

  • Adult
  • Brain Neoplasms* / genetics
  • Brain Neoplasms* / pathology
  • Brain Neoplasms* / therapy
  • Chromosome Deletion
  • Chromosomes, Human, Pair 1* / genetics
  • Chromosomes, Human, Pair 19* / genetics
  • Humans
  • Isocitrate Dehydrogenase* / genetics
  • Middle Aged
  • Mutation*
  • Neoadjuvant Therapy*
  • Oligodendroglioma* / genetics
  • Oligodendroglioma* / pathology
  • Oligodendroglioma* / therapy
  • Prognosis
  • Standard of Care*
  • Survival Rate

Substances

  • Isocitrate Dehydrogenase
  • IDH1 protein, human