Therapy for Diffuse Astrocytic and Oligodendroglial Tumors in Adults: ASCO-SNO Guideline

Abstract Purpose To provide guidance to clinicians regarding therapy for diffuse astrocytic and oligodendroglial tumors in adults. Methods ASCO the Society Neuro-Oncology convened an Expert Panel conducted a systematic review of literature. Results Fifty-nine randomized trials focusing on therapeutic management were identified. Recommendations Adults with newly diagnosed oligodendroglioma, isocitrate dehydrogenase (IDH)–mutant, 1p19q codeleted CNS WHO grade 2 3 should be offered radiation (RT) procarbazine, lomustine, vincristine (PCV). Temozolomide (TMZ) is reasonable alternative patients who may not tolerate PCV, but no high-level evidence supports upfront TMZ this setting. People astrocytoma, IDH-mutant, non-codeleted RT adjuvant chemotherapy (TMZ or PCV). TMZ. 4 follow recommendations either glioblastoma, IDH-wildtype, 4. Concurrent followed by 6 months Alternating electric field therapy, approved US Food Drug Administration, considered these patients. Bevacizumab recommended. In situations which benefits 6-week plus outweigh harms, hypofractionated reasonable. age ≥ 60 70 years, poor performance status whom toxicity prognosis are concerns, best supportive care alone, alone (for MGMTpromoter unmethylated tumors), MGMT promoter methylated tumors) treatment options. Additional information available at www.asco.org/neurooncology-guidelines.