Advances in IDH-mutant glioma management: IDH inhibitors, clinical implications of INDIGO trial, and future perspectives
- PMID: 40424199
- PMCID: PMC12218491
- DOI: 10.1080/14796694.2025.2511587
Advances in IDH-mutant glioma management: IDH inhibitors, clinical implications of INDIGO trial, and future perspectives
Abstract
The discovery of isocitrate dehydrogenase (IDH) mutation in gliomas marked the new era of molecular classification of CNS tumors. Understanding the complex role of IDH mutation in oncogenesis led to the evaluation of novel small molecules targeting this enzyme as a potential therapeutic intervention. Vorasidenib, a brain-penetrant inhibitor of both IDH1 and IDH2-mutant enzymes, was one such agent. The phase 3 INDIGO trial evaluated vorasidenib and demonstrated its efficacy in IDH-mutant low-grade gliomas (LGG). This study established vorasidenib as an effective inhibitor of both IDH1 and IDH2-mutant enzymes, highlighting its great potential in advancing the therapeutic armamentarium for patients with LGG. While vorasidenib has been recently included in several treatment guidelines for CNS tumors, further research on the use of this novel agent, as monotherapy or in combination with other drugs, becomes imperative to exploit fully its potential in the management of IDH-mutant gliomas.
Keywords: 2-hydroxyglutarate (2-HG); Glioma; IDH inhibitor; isocitrate dehydrogenase (IDH); vorasidenib.
Conflict of interest statement
Christianne V. Mojica received honorarium from Servier Canada. Katrina Mari E. Gutierrez received honorarium from Servier Canada. Warren P. Mason received consulting fees, grants, and academic lectures honoraria from Servier Canada and Novocure and also consulting fees from Boehringer Ingelheim, and took part in the Servier Canada, Boehringer Ingelheim, Novocure, and Ono Therapeutics advisory boards. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
Similar articles
-
A Promising Breakthrough: The Potential of VORASIDENIB in the Treatment of Low-grade Glioma.Curr Mol Pharmacol. 2024;17:e18761429290327. doi: 10.2174/0118761429290327240222061812. Curr Mol Pharmacol. 2024. PMID: 38425121 Review.
-
The role of vorasidenib in the treatment of isocitrate dehydrogenase-mutant glioma.Neuro Oncol. 2025 Jun 21;27(5):1135-1148. doi: 10.1093/neuonc/noae259. Neuro Oncol. 2025. PMID: 39723472 Review.
-
Low-grade IDH-mutant gliomas: from standard post-surgical treatments to novel IDH inhibitors.Expert Opin Pharmacother. 2025 Jul;26(10):1163-1175. doi: 10.1080/14656566.2025.2516617. Epub 2025 Jun 6. Expert Opin Pharmacother. 2025. PMID: 40479721 Review.
-
Vorasidenib in IDH1- or IDH2-Mutant Low-Grade Glioma.N Engl J Med. 2023 Aug 17;389(7):589-601. doi: 10.1056/NEJMoa2304194. Epub 2023 Jun 4. N Engl J Med. 2023. PMID: 37272516 Free PMC article. Clinical Trial.
-
The IDH paradox: Meta-analysis of alkylating chemotherapy in IDH-wild type and -mutant lower grade gliomas.Neuro Oncol. 2024 Oct 3;26(10):1839-1849. doi: 10.1093/neuonc/noae102. Neuro Oncol. 2024. PMID: 38943513 Free PMC article.
References
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous