Highlights From the Annual Neuro-Oncology Conference: Integrating IDH Inhibitor Therapy Into Glioma Care Authors: Maciej Mrugala, MD, PhD, MPH; Rimas V. Lukas, MD; Yoshie Umemura, MD

https://www.medscape.org/viewarticle/1003175?sso=true&uac=148436CN&src=mkmcmr_reeng_recap_mscpedu_activity Cerasale Victor, thank you for your recent participation in the activity: Highlights From the Annual Neuro-Oncology Conference: Integrating IDH Inhibitor Therapy Into Glioma Care Below are some key learning points to help reinforce the impact of this activity. ☑ IDH Mutations and Therapeutic Implications: IDH1/2 mutations occur in 70% to 80% of lower-grade gliomas. The INDIGO trial demonstrated that IDH inhibitor vorasidenib significantly extended progression-free survival and time to next intervention compared to placebo in IDH1/2-mutant grade 2 glioma. INDIGO also showed vorasidenib was associated with 2.8x fewer seizures per person-year, providing additional quality-of-life benefits beyond disease control. ☑ Clinical Decision-Making Framework: Management decisions involve balancing molecular status, tumor characteristics (grade, enhancement pattern, location), prior interventions, and patient-specific factors. Vorasidenib is currently EMA- and FDA-approved in grade 2 IDH1/2-mutant glioma following biopsy, sub-total or gross total resection. ☑ Real-World Implementation Challenges: Multidisciplinary tumor board discussions are essential for complex cases including enhancing vs nonenhancing disease. Logistical challenges may include medication availability, patient-specific factors (e.g., lack of transport), adherence, family planning, and fertility preservation. ☑ Evolving Treatment Paradigm: Multiple clinical trials are investigating IDH inhibitors in various scenarios, including combination with chemotherapy, immunotherapy, and in grade 3 disease. These studies, along with exploration of novel IDH inhibitors such as safusidenib, olutasidenib and zotiraciclib, will help clarify optimal integration into treatment algorithms and potentially expand therapeutic options.