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Review
. 2025 Jan-Feb;31(1):e0760.
doi: 10.1097/PPO.0000000000000760.

Management of Low-Grade Gliomas

Maria Diaz  1 , Peter C Pan
Affiliations
Review

Management of Low-Grade Gliomas

Maria Diaz et al. Cancer J. 2025 Jan-Feb.

Abstract

The term "low-grade glioma" historically refers to adult diffuse gliomas that exhibit a less aggressive course than the more common high-grade gliomas. In the current molecular era, "low-grade" refers to World Health Organization central nervous system grade 2 gliomas almost always with an isocitrate dehydrogenase (IDH) mutation (astrocytomas and oligodendrogliomas). The term "lower-grade gliomas" has emerged encompassing grades 2 and 3 IDH-mutant astrocytomas and oligodendrogliomas, to acknowledge that histological grade is not as important a prognostic factor as molecular features, and distinguishing them from grade 4 glioblastomas, which lack an IDH mutation. These grades 2 and 3 IDH-mutant tumors are characterized by indolent growth but are ultimately incurable in most cases, presenting significant management challenges. Physicians must carefully weigh all available evidence to balance improvements in survival from new treatments against treatment toxicities. This review summarizes the evidence guiding the treatment of these patients.

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Conflict of interest statement

Conflicts of Interest and Source of Funding: The authors are supported in part by The William Rhodes and Louise Tilzer-Rhodes Center for Glioblastoma at NewYork-Presbyterian Hospital (P.C.P., M.D.), the National Cancer Institute–designated Herbert Irving Comprehensive Cancer Center (M.D.), and the Matheson Foundation (M.D.). The authors are investigators, and our institution has received research support for participation in the following studies: NCT05303519 (safusidenib, AnHeart Therapeutics; investigators P.C.P., M.D.), NCT05879367 (eflornithine, Orbus Therapeutics; investigators P.C.P., M.D.), NCT03557359 (nivolumab, Bristol-Myers Squibb; investigators P.C.P.), and NCT04164901 (AG-881/vorasidenib, Servier; investigators P.C.P., M.D.).

Figures

FIGURE 1
FIGURE 1
Management schematic for adult-type LGGs.
See this image and copyright information in PMC

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