Optimizing treatment for patients with low-grade gliomas should focus on the role of radiation and chemotherapy, as well as the prognostic impact of molecular diagnostics (1p/19q and IDH status). For anaplastic oligodendroglioma, focus should be placed on molecular markers (particularly 1p/19q status) and combination treatment with chemotherapy (temozolomide or PCV [procarbazine, lomustine, and vincristine]) and radiation. For patients with malignant glioblastomas, the role of methylguanine methyl-transferase (MGMT) methylation status has become increasingly important to treatment decisions. MGMT methylation status should be considered in elderly patients and/or those with low performance status (methylated patients benefit from temozolomide) and a hypofractionated radiation schedule should be used.
Disclosures: Dr. Nabors has disclosed that he is a scientific advisor for AbbVie, Inc., BTG Pharmaceuticals, Karyopharm Therapeutics, Blue Earth Diagnostics, and Kiyatec.
Correspondence: Louis Burt Nabors, MD, O’Neal Comprehensive Cancer Center at UAB, 510 20th Street South, FOT 1020, Birmingham, AL 35294. Email: firstname.lastname@example.org
YabroffKR, LundJ, KepkaD, .Economic burden of cancer in the United States: estimates, projections, and future research. Cancer Epidemiol Biomarkers Prev 2011;20:2006–2014.10.1158/1055-9965.EPI-11-065021980008)| false
OstromQT, GittlemanH, XuJ, .CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2009-2013. Neuro Oncol 2016;18(Suppl 5):v1–75.10.1093/neuonc/now20728475809)| false
van den BentMJ, BrandesAA, TaphoornMJB, . Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC Brain Tumor Group Study 26951. J Clin Oncol2013;31:344–350.
van den BentMJ, BrandesAA, TaphoornMJB, . Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC Brain Tumor Group Study 26951. J Clin Oncol 2013;31:344–350.10.1200/JCO.2012.43.2229)| false
Cancer Genome Atlas Research Network, BratDJ, VerhaakRGW, . Comprehensive, integrative genomic analysis of diffuse lower-grade gliomas. N Engl J Med 2015;372:2481–2498.2606175110.1056/NEJMoa1402121)| false