Oligodendroglioma
ICD-10 C71.9 · ICD-11 2A00.0&XH7W59

Treatment of WHO Grade 2 Oligodendroglioma with IDH Mutation and 1p19q Codeletion After Complete Surgical Resection

Clinical Scenario

This protocol addresses the management of adults with CNS WHO grade 2 oligodendroglioma carrying an IDH mutation and 1p19q codeletion who have undergone complete surgical resection of the brain tumor.

In patients with favorable prognostic factors — such as complete resection and younger age — initial radiation therapy and chemotherapy may be deferred until radiographic or symptomatic progression rather than started immediately after surgery.

Treatment Approach

When initial radiation therapy and chemotherapy are deferred following one or more surgeries, vorasidenib is among the treatment options considered — the full protocol specifies the complete clinical criteria, sequencing, and decision points that determine its use.

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References

DOI: 10.1200/JCO-25-00250

Within the group of people with oligodendroglioma, IDH-mutant, 1p19q codeleted, CNS WHO grade 2, initial radiation therapy and chemotherapy (with PCV or temozolomide) may be deferred until radiographic or symptomatic progression in some people with favorable prognostic factors (eg, complete resection and younger age) or concerns about toxicity.

Vorasidenib may be offered to people with oligodendroglioma, IDH-mutant, 1p19q codeleted, CNS WHO grade 2, where, after one or more surgeries, further treatment with radiation and chemotherapy has been or can be deferred (Evidence quality: High; Strength of recommendation: Conditional).

People who are seeking pregnancy as either father or mother and people who are pregnant or breast feeding should not be offered vorasidenib.

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