Unlocking new horizons: advances in treating IDH-mutant, 1p/19q-codeleted oligodendrogliomas

Abstract Oligodendrogliomas are a distinct subtype of diffuse gliomas characterized by IDH mutations and 1p/19q codeletion, classified as grade 2 or 3 based on histological features. This review examines current advancements in the diagnosis, treatment, and prognosis of oligodendrogliomas, with an e...

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Main Authors: Jing Bao, Zhenjiang Pan, Shepeng Wei
Format: Article
Language:English
Published: Springer 2025-05-01
Series:Discover Oncology
Subjects:
Online Access:https://doi.org/10.1007/s12672-025-02815-6
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author Jing Bao
Zhenjiang Pan
Shepeng Wei
author_facet Jing Bao
Zhenjiang Pan
Shepeng Wei
author_sort Jing Bao
collection DOAJ
description Abstract Oligodendrogliomas are a distinct subtype of diffuse gliomas characterized by IDH mutations and 1p/19q codeletion, classified as grade 2 or 3 based on histological features. This review examines current advancements in the diagnosis, treatment, and prognosis of oligodendrogliomas, with an emphasis on personalized approaches driven by molecular insights. Surgery remains the cornerstone of treatment, aiming for maximal safe resection to obtain tissue for diagnosis and alleviate symptoms. For grade 2 tumors with residual disease but no symptomatic progression, the IDH inhibitor vorasidenib has emerged as a promising option to delay the need for radiation therapy (RT) and chemotherapy. For grade III oligodendrogliomas, postoperative combined-modality therapy with RT and chemotherapy, such as the PCV regimen, demonstrates significant survival benefits, while temozolomide is an alternative due to its ease of administration and reduced toxicity. Recurrent oligodendrogliomas present therapeutic challenges, necessitating tailored strategies based on prior treatments and the interval since initial therapy. Options include repeat surgery, reirradiation, or novel targeted therapies. Advances in molecular diagnostics, such as homozygous CDKN2A/B deletion as a prognostic marker, have refined risk stratification and informed treatment decisions. Despite these strides, further research is needed to optimize long-term outcomes and address resistance mechanisms. This review underscores the importance of integrating molecular diagnostics with clinical management to achieve personalized, evidence-based care for patients with oligodendrogliomas.
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spelling doaj-art-8f57039377aa4d2dba2363f10091ffe02025-08-20T02:03:36ZengSpringerDiscover Oncology2730-60112025-05-0116112210.1007/s12672-025-02815-6Unlocking new horizons: advances in treating IDH-mutant, 1p/19q-codeleted oligodendrogliomasJing Bao0Zhenjiang Pan1Shepeng Wei2Department of Neurosurgery, Shidong HospitalDepartment of Neurosurgery, Shidong HospitalDepartment of Neurosurgery, Shidong HospitalAbstract Oligodendrogliomas are a distinct subtype of diffuse gliomas characterized by IDH mutations and 1p/19q codeletion, classified as grade 2 or 3 based on histological features. This review examines current advancements in the diagnosis, treatment, and prognosis of oligodendrogliomas, with an emphasis on personalized approaches driven by molecular insights. Surgery remains the cornerstone of treatment, aiming for maximal safe resection to obtain tissue for diagnosis and alleviate symptoms. For grade 2 tumors with residual disease but no symptomatic progression, the IDH inhibitor vorasidenib has emerged as a promising option to delay the need for radiation therapy (RT) and chemotherapy. For grade III oligodendrogliomas, postoperative combined-modality therapy with RT and chemotherapy, such as the PCV regimen, demonstrates significant survival benefits, while temozolomide is an alternative due to its ease of administration and reduced toxicity. Recurrent oligodendrogliomas present therapeutic challenges, necessitating tailored strategies based on prior treatments and the interval since initial therapy. Options include repeat surgery, reirradiation, or novel targeted therapies. Advances in molecular diagnostics, such as homozygous CDKN2A/B deletion as a prognostic marker, have refined risk stratification and informed treatment decisions. Despite these strides, further research is needed to optimize long-term outcomes and address resistance mechanisms. This review underscores the importance of integrating molecular diagnostics with clinical management to achieve personalized, evidence-based care for patients with oligodendrogliomas.https://doi.org/10.1007/s12672-025-02815-6IDH-mutant oligodendrogliomas1p/19q codeletionMolecular diagnosticsPersonalized therapyPrognostic markers
spellingShingle Jing Bao
Zhenjiang Pan
Shepeng Wei
Unlocking new horizons: advances in treating IDH-mutant, 1p/19q-codeleted oligodendrogliomas
Discover Oncology
IDH-mutant oligodendrogliomas
1p/19q codeletion
Molecular diagnostics
Personalized therapy
Prognostic markers
title Unlocking new horizons: advances in treating IDH-mutant, 1p/19q-codeleted oligodendrogliomas
title_full Unlocking new horizons: advances in treating IDH-mutant, 1p/19q-codeleted oligodendrogliomas
title_fullStr Unlocking new horizons: advances in treating IDH-mutant, 1p/19q-codeleted oligodendrogliomas
title_full_unstemmed Unlocking new horizons: advances in treating IDH-mutant, 1p/19q-codeleted oligodendrogliomas
title_short Unlocking new horizons: advances in treating IDH-mutant, 1p/19q-codeleted oligodendrogliomas
title_sort unlocking new horizons advances in treating idh mutant 1p 19q codeleted oligodendrogliomas
topic IDH-mutant oligodendrogliomas
1p/19q codeletion
Molecular diagnostics
Personalized therapy
Prognostic markers
url https://doi.org/10.1007/s12672-025-02815-6
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AT shepengwei unlockingnewhorizonsadvancesintreatingidhmutant1p19qcodeletedoligodendrogliomas