How would you manage a patient less than 40 years old with an incidentally found LGG, IDH mutated, 1p19q intact, s/p STR?
Would you offer radiation and chemotherapy, vorasidenib, or observation?
Answer from: Radiation Oncologist at Academic Institution
Update: On August 6, 2024, the FDA approved Vorasidenib for IDH-mutant low-grade gliomas based on findings from the INDIGO trial. This decision highlights the FDA's incompetence and lack of scientific integrity, clearly demonstrating that the agency prioritizes pharmaceutical companies' interests ov...
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Radiation Oncologist at University of Arizona Cancer Center Excellent response. Thank you for taking the time ...
Answer from: Radiation Oncologist at Academic Institution
The management for classic WHO grade 2 gliomas is increasingly becoming complex, especially with recent results from the INDIGO trial. In the context of this patient, there are two favorable risk factors, i.e. age <40, and IDH mutated, also but the fact that there are two unfavorable risk factors...
Answer from: Radiation Oncologist at Academic Institution
A patient with LGG, IDHm, <40 yo, who has had a subtotal resection would qualify for high risk on the basis of the sub-total resection per RTOG 9802 eligibility criteria. On that trial, he would have been randomized to RT vs RT+PCV chemo.This trial showed a significant improvement in the PFS but ...
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Radiation Oncologist at Thomas Jefferson University What is most impressive to me about RTOG 9802 is t...
Radiation Oncologist at WellSpan Radiation Oncology Thanks Dr. @Alexander! I completely agree with you...
Answer from: Radiation Oncologist at Academic Institution
One should first determine the reason that the tumor was sub-totally resected. A common reason is that the tumor is close to an eloquent area of the brain. If that is the case, I would recommend treatment because a tumor recurrence could cause functional deficit by invading the adjacent eloquent are...
Excellent response. Thank you for taking the time ...