Highlights From the Annual Neuro-Oncology Conference: Redefining IDH-Mutant Glioma Management Authors: Evanthia Galanis, MD; Shawn Hervey-Jumper, MD; Katherine B. Peters, MD, PhD, FAAN; Matthias Preusser, MD

https://www.medscape.org/viewarticle/1003198?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: Redefining IDH-Mutant Glioma Management Below are some key learning points to help reinforce the impact of this activity. ☑ Isocitrate dehydrogenase (IDH)-mutant gliomas are classified by the World Health Organization as astrocytomas (grades 2 to 4) or oligodendrogliomas (grades 2 to 3) with distinct molecular profiles. Management goals focus on both survival and quality of life (QOL), as these typically affect younger patients (30 to 40 years). ☑ Maximal safe resection remains the foundation of treatment for IDH-mutant gliomas. Advanced surgical technologies, including intraoperative magnetic resonance imaging, 5-aminolevulinic acid-induced fluorescence, neuronavigation, ultrasound, and Raman spectroscopy, are increasingly used to enhance resection extent. ☑ Vorasidenib, an oral IDH1/2 inhibitor, received US Food and Drug Administration/European Medicines Agency approval for grade 2 IDH-mutant gliomas after surgery based on the INDIGO trial, which demonstrated significant improvement in progression-free survival vs placebo. What's more, neurocognitive function and health related QOL were preserved, and seizure frequency was reduced. ☑ Current clinical trials are evaluating vorasidenib in higher-grade tumors and maintenance settings after chemoradiation (ALLIANCE, VIGOR trials). Alternative IDH inhibitors (ivosidenib, olutasidenib, and safusidenib) and novel approaches, including IDH-targeted vaccines, represent promising emerging therapeutic strategies. ☑ Treatment decisions for IDH-mutant gliomas require multidisciplinary assessment considering risk factors: extent of resection, enhancement pattern, growth rate, neurological deficits, and molecular characteristics. For high-risk tumors, adjuvant radiation therapy with chemotherapy significantly improves survival outcomes.