6 days ago
Brain Tumors Clinical Practice Guidelines (2025)
Editorial Note: These are some of the highlights of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.
Updated guidelines on therapy of adult diffuse astrocytic and oligodendroglial tumors were published in April 2025 by the American Society of Clinical Oncology and the Society for Neuro-Oncology in the Journal of Clinical Oncology .[1]
In patients with oligodendroglioma that is IDH -mutant, 1p19q co-deleted, central nervous system (CNS) World Health Organization (WHO) grade 2, offer radiation in combination with procarbazine, lomustine (CCNU), and vincristine (PCV). If toxicity is a concern, temozolomide is a reasonable alternative to PCV.
Consider offering vorasidenib to patients who have oligodendroglioma that is IDH -mutant, 1p19q codeleted, CNS WHO grade 2; who have undergone one or more surgeries; and in whom further treatment with radiation and chemotherapy has been or can be deferred.
In astrocytoma that is IDH -mutant, 1p19q non-codeleted, CNS WHO grade 2, initial radiation therapy and chemotherapy (with temozolomide or PCV) may be deferred until radiographic or symptomatic progression in some patients with favorable prognostic factors (eg, complete resection, younger age) or concerns about short- and long-term toxicity.
Consider offering vorasidenib in patients who have astrocytoma that is IDH -mutant, 1p19q non-codeleted, CNS WHO grade 2; who have undergone one or more surgeries; and in whom further treatment with radiation and chemotherapy has been or can be deferred.
For more information, please go to Brain Neoplasms.
