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

This protocol covers the management of adults with CNS WHO grade 2 oligodendroglioma carrying an IDH mutation and 1p19q codeletion, following complete surgical resection of the brain tumor. Patients are not pregnant, not breast feeding, and not seeking pregnancy.

Clinical scenario

Treatment approach

The recommended approach involves radiation therapy combined with a multi-agent chemotherapy regimen. An alternative chemotherapy option exists when tolerability is a concern.

In some patients with favorable prognostic factors, initiation of treatment may be deferred. Full regimen selection, sequencing, and individualized decision criteria are available in the complete protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1200/JCO-25-00250

  1. 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.
  2. People who are seeking pregnancy as either father or mother and people who are pregnant or breast feeding should not be offered vorasidenib.
  3. People with oligodendroglioma, IDH-mutant, 1p19q co-deleted, CNS WHO grade 2 should be offered radiation in combination with procarbazine, lomustine, and vincristine (PCV) (Evidence quality: Moderate; Strength of recommendation: Strong).
  4. Temozolomide is a reasonable alternative to PCV when toxicity is a concern (Evidence quality: Low; Strength of recommendation: Conditional).
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