Is chemotherapy alone an option as initial treatment for low-grade oligodendrogliomas?
Journal
Current opinion in neurology
ISSN: 1473-6551
Titre abrégé: Curr Opin Neurol
Pays: England
ID NLM: 9319162
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
pubmed:
8
10
2020
medline:
1
7
2021
entrez:
7
10
2020
Statut:
ppublish
Résumé
The management of low-grade (grade II) oligodendrogliomas is still controversial, due to their rarity and long-term survival. According to recent WHO 2016 Classification of central nervous system tumors oligodendrogliomas are defined by the coexistence of molecular alterations, such as isocitrate dehydrogenase (IDH)1/2 mutations and 1p/19q codeletion. These tumors have better outcome and higher response to chemotherapy compared with diffuse astrocytomas. The association of radiotherapy and procarbazine, lomustine (CCNU), vincristine chemotherapy in low-grade oligodendrogliomas is definitely superior over radiotherapy alone, and yields median progression-free survival and overall survival values exceeding by far 10 years. Chemotherapy alone yields results that are inferior compared with radiotherapy + procarbazine, CCNU, vincristine but may better preserve cognitive functions from radiotherapy-induced damage. Chemosensitivity of oligodendrogliomas is related to a high percentage of O6-methylguanine-DNA methyltransferase methylation and low expression of DNA repair genes. Recurrent defects in mismatch repair pathways may induce hypermutation and secondary resistance to temozolomide, but not to nitrosoureas. Reoperation at progression following initial chemotherapy is increasingly adopted, thus allowing a further delay of radiotherapy. In the future targeting IDH1/2 mutations following incomplete surgery may represent a new innovative option.
Identifiants
pubmed: 33027142
doi: 10.1097/WCO.0000000000000866
pii: 00019052-202012000-00008
doi:
Substances chimiques
Antineoplastic Agents
0
Vincristine
5J49Q6B70F
Lomustine
7BRF0Z81KG
Temozolomide
YF1K15M17Y
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
707-715Références
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