Este protocolo se aplica a adultos con astrocitoma anaplásico, grado 3 de la OMS del SNC, en quienes las pruebas moleculares confirman la ausencia de una mutación IDH (IDH-nativo). Este hallazgo molecular es un determinante clave del enfoque de tratamiento para esta población.
Los detalles completos del protocolo — todos los componentes, secuenciación, criterios de elegibilidad — están disponibles a través del régimen estructurado a continuación.
DOI: 10.1093/neuonc/noab279
People with astrocytomas, IDH-wildtype, CNS WHO grade 2 or 3 may be treated according to recommendations for glioblastoma, IDH-wildtype, CNS WHO grade 4 found in this guideline (Type: informal consensus; Evidence quality: very low; Strength of recommendation: weak).
Concurrent TMZ and RT should be offered to people with newly diagnosed glioblastoma, IDH-wildtype, CNS WHO grade 4 (Type: evidence-based, benefits outweigh harms; Evidence quality: moderate; Strength of recommendation: strong).
Six months of adjuvant TMZ should be offered to people with newly diagnosed glioblastoma, IDH-wildtype, CNS WHO grade 4 who have received concurrent RT plus TMZ (Type: evidence-based, benefits outweigh harms; Evidence quality: moderate; Strength of recommendation: strong).
Alternating electric field therapy may be added to adjuvant TMZ in people with newly diagnosed supratentorial glioblastoma, IDH-wildtype, CNS WHO grade 4 who have completed chemoradiation therapy (Type: evidence-based, benefits outweigh harms; Evidence quality: moderate; Strength of recommendation: weak).
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