Low-grade and anaplastic oligodendroglioma

Martin J. Van Den Bent, Jacolien E C Bromberg, Jan Craig Buckner

Research output: Chapter in Book/Report/Conference proceedingConference contribution

10 Scopus citations

Abstract

Anaplastic oligodendrogliomas have long attracted interest because of their sensitivity to chemotherapy, in particular in the subset of 1p/19q co-deleted tumors. Recent molecular studies have shown that all 1p/19q co-deleted tumors have IDH mutations and most of them also have TERT mutations. Because of the presence of similar typical genetic alterations in astrocytoma and glioblastoma, the current trend is to diagnose these tumors on the basis of their molecular profile. Further long-term follow-up analysis of both EORTC and RTOG randomized studies on (neo)adjuvant procarbazine, lomustine, vincristine (PCV) chemotherapy have shown that adjuvant chemotherapy indeed improves outcome, and this is now standard of care. It is also equally clear that benefit to PCV chemotherapy is not limited to the 1p/19q co-deleted cases; potential other predictive factors are IDH mutations and MGMT promoter methylation. Moreover, a recent RTOG study on low-grade glioma also noted an improved outcome after adjuvant PCV chemotherapy, thus making (PCV) chemotherapy now standard of care for all 1p/19q co-deleted tumors regardless of grade. It remains unclear whether temozolomide provides the same survival benefit, as no data from well-designed clinical trials on adjuvant temozolomide in this tumor type are available. Another question that remains is whether one can safely leave out radiotherapy as part of initial treatment to avoid cognitive side-effects of radiotherapy. The current data suggest that delaying radiotherapy and treatment with chemotherapy only may be detrimental for overall survival.

Original languageEnglish (US)
Title of host publicationGliomas, 2016
PublisherElsevier
Pages361-380
Number of pages20
Volume134
ISBN (Print)9780128029978
DOIs
StatePublished - 2016

Publication series

NameHandbook of Clinical Neurology
Volume134
ISSN (Print)00729752
ISSN (Electronic)22124152

Keywords

  • 19q
  • 1p
  • Anaplastic
  • IDH
  • Oligoastrocytoma
  • Oligodendroglioma
  • PCV
  • Temozolomide
  • TERT

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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  • Cite this

    Van Den Bent, M. J., Bromberg, J. E. C., & Buckner, J. C. (2016). Low-grade and anaplastic oligodendroglioma. In Gliomas, 2016 (Vol. 134, pp. 361-380). (Handbook of Clinical Neurology; Vol. 134). Elsevier. https://doi.org/10.1016/B978-0-12-802997-8.00022-0