Treatment of Adult Oligodendroglioma (CNS WHO Grade 2) with IDH Mutation and 1p/19q Codeletion
This protocol addresses adult patients with a confirmed diagnosis of oligodendroglioma, CNS WHO grade 2, defined by two hallmark molecular features: an IDH mutation and 1p/19q codeletion. The combination of these molecular characteristics shapes the treatment approach for this population.
Adult patient with oligodendroglioma, CNS WHO grade 2, with IDH mutation and 1p/19q codeletion confirmed on molecular testing. This is a first-line treatment setting.
Evidence-based management for this population involves radiation therapy used in combination with a multi-agent chemotherapy regimen. When tolerability is a concern, an alternative chemotherapy approach may be appropriate. The complete regimen, agent selection, sequencing, and individualized considerations are detailed in the full protocol.
References
DOI: 10.1200/JCO-25-00250
- 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).
- Temozolomide is a reasonable alternative to PCV when toxicity is a concern (Evidence quality: Low; Strength of recommendation: Conditional).
- The panel notes that the FDA approval and the INDIGO trial itself included patients as young as age 12 years; the ASCO-SNO guideline and this update only address adult patients.