Treatment
Oligodendroglioma, IDH-mutant, 1p/19q co-deleted, CNS WHO grade 3
(former anaplastic oligodendroglioma)
Recommendation 1.3
➤ People with oligodendroglioma, IDH-mutant, 1p/19q co-deleted, CNS
WHO grade 3 should be offered radiation therapy 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)
Astrocytoma, IDH-mutant, 1p/19q non-codeleted, CNS WHO grade 2
(former diffuse astrocytoma)
Recommendation 1.4
➤ People with astrocytoma, IDH-mutant, 1p/19q non-codeleted, CNS
WHO grade 2 (low grade diffuse glioma) should be offered radiation
therapy with adjuvant chemotherapy (temozolomide or PCV). (Strong
recommendation; EB-B-M [IC regarding temozolomide])
Recommendation 1.5
➤ In astrocytoma, IDH-mutant, 1p/19q non-codeleted, 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, younger age) or concerns about short- and long- term toxicity
given the natural history of the disease. See guideline for more details.
(Moderate recommendation; IC-B-I)
Astrocytoma, IDH-mutant, 1p/19q non-codeleted, CNS WHO grade 2
(former diffuse astrocytoma)
Recommendation 1.6
➤ People with astrocytoma, IDH-mutant, 1p/19q non-codeleted CNS WHO
grade 3 should be offered radiation therapy with adjuvant temozolomide.
(Strong recommendation; EB-B-M)
Astrocytoma, IDH-mutant, CNS WHO grade 4
(former IDH-mutant glioblastoma)
Recommendation 1.7
➤ People with astrocytoma, IDH-mutant CNS WHO grade 4 may be treated
like an astrocytoma, IDH-mutant, non-codeleted, CNS WHO grade 3
(former anaplastic astrocytoma) (see Recommendation 1.6) or like a
glioblastoma, IDH-wildtype, CNS WHO grade 4 (former IDH-wildtype
glioblastoma) (see Recommendation 2.2). (Weak recommendation; IC-VL)
