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Oligodendroglioma, IDH-mutant and 1p/19q-codeleted-prognostic factors, standard of care and chemotherapy, and future perspectives with neoadjuvant strategy

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Abstract

Oligodendroglioma, IDH-mutant and 1p/19q-codeleted is known for their relative chemosensitivity and indolent clinical course among diffuse gliomas of adult type. Based on the data from phase 3 clinical trials, the standard of post-surgical care for those tumors is considered to be initial chemoradiotherapy regardless of histopathological grade, particularly with PCV. However, partly due to its renewed definition in late years, prognostic factors in patients with those tumors are not well established. Moreover, the survival rate declines over 15 years, with only a 37% OS rate at 20 years for grade 3 tumors, even with the current standard of care. Given that most of this disease occurs in young or middle-aged adults, further improvements in treatment and management are necessary. Here, we discuss prognostic factors, standard of care and chemotherapy, and future perspectives with neoadjuvant strategy in those tumors.

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Abbreviations

CDKN2A HD:

CDKN2A homozygous deletion

EORTC:

European organization for research and treatment of cancer

IDH:

Isocitrate dehydrogenase

IDHmut:

IDH-mutant

LGG:

Low grade glioma, i.e., grade 2 diffuse glioma, defined by WHO2016

LrGG:

Lower grade gliomas, i.e., grade 2 or 3 diffuse gliomas, defined by WHO2016

MVP:

Microvascular proliferation

OS:

Overall survival

PCV:

Procarbazine, CCNU (lomustine), and vincristine

PAV:

Procarbazine, ACNU (nimustine), and vincristine

PFS:

Progression free survival

RTOG:

Radiation therapy oncology group

TTP:

Time to progression

WHO2016:

WHO Classification of Tumours. Central neuvous system tumours. Revised 4th Ed.

WHO2021:

WHO Classification of Tumours. Central neuvous system tumours. 5th Ed.

1p/19qcodel:

1P/19q-codeleted

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Acknowledgements

We thank very much for every support by corroborators in multiple institutions.

Funding

The present work was supported in part by Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science [15K10343, 19K09490 to H.S.], and by research grant from Eisai Japan [HHCS20200922004 to H.S.].

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Authors and Affiliations

  1. Department of Neurosurgery, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa, Chiba, 272-8523, Japan

    Hikaru Sasaki

  2. Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Hikaru Sasaki, Yohei Kitamura, Masahiro Toda & Kazunari Yoshida

  3. Department of Neurosurgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoake, Aichi, 470-1192, Japan

    Yuichi Hirose

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  1. Hikaru Sasaki
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Corresponding author

Correspondence to Hikaru Sasaki.

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Conflict of interest

HS received grant for clinical trial which was not related to the contents of the present work from Ono pharmaceutical. HS received research grant from Eisai pharmaceutical in 2020 and 2021, a part of which was used for histological study. The authors declare there is no conflict of interest concerning the contents of the present work.

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Treatment with neoadjuvant strategy and histopathological investigation were performed with approval by the institutional review board (20130250, 20050002).

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Sasaki, H., Kitamura, Y., Toda, M. et al. Oligodendroglioma, IDH-mutant and 1p/19q-codeleted-prognostic factors, standard of care and chemotherapy, and future perspectives with neoadjuvant strategy. Brain Tumor Pathol 41, 43–49 (2024). https://doi.org/10.1007/s10014-024-00480-1

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  • DOI: https://doi.org/10.1007/s10014-024-00480-1

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