Key Points
➤ Each year, more than 15,000 people in the United States are newly
diagnosed with diffuse astrocytic and oligodendroglial tumors, including
glioblastoma.
➤ Recently, several systemic agents and a device have demonstrated
improvements in survival when added to surgical and radiation therapies.
➤ Genetic alterations, specifically Isocitrate Dehydrogenase 1 and 2 (IDH1
and IDH2 ), have become critical classification and prognostic biomarkers.
Treatment
IDH-mutant Astrocytic and Oligodendroglial Tumors
Oligodendroglioma, IDH-mutant, 1p/19q co-deleted, CNS WHO grade 2
Recommendation 1.1
➤ People with oligodendroglioma, IDH-mutant, 1p/19q co-deleted, CNS
WHO grade 2 should be offered radiation in combination with PCV.
(Strong recommendation; EB-B-M)
• Temozolomide is a reasonable alternative to PCV when toxicity is a concern.
(Weak recommendation; IC-L)
Recommendation 1.2
➤ Within the group of people with oligodendroglioma, IDH-mutant, 1p/19q
co-deleted, CNS WHO grade 2, initial therapy may be deferred until
radiographic or symptomatic progression in some people with positive
prognostic factors (e.g., complete resection and younger age) or concerns
about toxicity. See guideline for more details. (Weak recommendation;
IC-L)
