Recent developments and future directions in adult lower-grade gliomas: Society for Neuro-Oncology (SNO) and European Association of Neuro-Oncology (EANO) consensus

Author:

Schiff David1,Van den Bent Martin2,Vogelbaum Michael A3,Wick Wolfgang4,Miller C Ryan5,Taphoorn Martin6,Pope Whitney7,Brown Paul D8,Platten Michael9,Jalali Rakesh10,Armstrong Terri11,Wen Patrick Y12

Affiliation:

1. Department of Neurology, University of Virginia, Charlottesville, Virginia

2. Department of Neurology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands

3. Department of Neurological Surgery, Cleveland Clinic, Cleveland, Ohio

4. Divison of Neuro-Oncology, German Cancer Research Center, Heidelberg, Germany

5. Pathology and Lab Medicine, University of North Carolina, Chapel Hill, North Carolina

6. Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

7. Section of Neuroradiology, UCLA, Los Angeles, California

8. Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota

9. Department of Neurology, Mannheim University Hospital, Mannheim, Germany

10. Apollo Proton Cancer Centre, Chennai, India

11. Neuro-Oncology Branch, National Institute of Health, Bethesda, Maryland

12. Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts

Abstract

Abstract The finding that most grades II and III gliomas harbor isocitrate dehydrogenase (IDH) mutations conveying a relatively favorable and fairly similar prognosis in both tumor grades highlights that these tumors represent a fundamentally different entity from IDH wild-type gliomas exemplified in most glioblastoma. Herein we review the most recent developments in molecular neuropathology leading to reclassification of these tumors based upon IDH and 1p/19q status, as well as the potential roles of methylation profiling and deletional analysis of cyclin-dependent kinase inhibitor 2A and 2B. We discuss the epidemiology, clinical manifestations, benefit of surgical resection, and neuroimaging features of lower-grade gliomas as they relate to molecular subtype, including advanced imaging techniques such as 2-hydroxyglutarate magnetic resonance spectroscopy and amino acid PET scanning. Recent, ongoing, and planned studies of radiation therapy and both cytotoxic and targeted chemotherapies are summarized, including both small molecule and immunotherapy approaches specifically targeting the mutant IDH protein.

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Clinical Neurology,Oncology

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