Expanded Use of Vorasidenib in Non-Enhancing Recurrent CNS WHO Grade 3 Oligodendroglioma
<b>Background/Objectives</b>: Anaplastic oligodendrogliomas (AOs) are central nervous system (CNS) World Health Organization (WHO) grade 3 gliomas characterized by isocitrate dehydrogenase (IDH) mutation (m)IDH and 1p/19q codeletion. AOs are typically treated with surgery and chemoradiat...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-01-01
|
| Series: | Biomedicines |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9059/13/1/201 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832589008371187712 |
|---|---|
| author | Alexander S. Himstead Jefferson W. Chen Eleanor Chu Mari A. Perez-Rosendahl Michelle Zheng Sherin Mathew Carlen A. Yuen |
| author_facet | Alexander S. Himstead Jefferson W. Chen Eleanor Chu Mari A. Perez-Rosendahl Michelle Zheng Sherin Mathew Carlen A. Yuen |
| author_sort | Alexander S. Himstead |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: Anaplastic oligodendrogliomas (AOs) are central nervous system (CNS) World Health Organization (WHO) grade 3 gliomas characterized by isocitrate dehydrogenase (IDH) mutation (m)IDH and 1p/19q codeletion. AOs are typically treated with surgery and chemoradiation. However, chemoradiation can cause detrimental late neurocognitive morbidities and an accelerated disease course. The recently regulatory-approved vorasidenib, a brain-penetrating oral inhibitor of IDH1/2, has altered the treatment paradigm for recurrent/residual non-enhancing surgically resected CNS WHO grade 2 mIDH gliomas. Though vorasidenib can delay the time to chemoradiation for grade 2 gliomas, the implications for vorasidenib in non-grade 2 mIDH gliomas are not well understood. <b>Results:</b> We present a case of a 71-year-old male with a grade 3 non-enhancing oligodendroglioma successfully treated with vorasidenib with an 11% reduction in residual tumor volume. Vorasidenib was well tolerated in our patient with a mild elevation in his liver transaminases that resolved following a brief interruption in treatment. <b>Conclusions:</b> Our case suggests that vorasidenib may impart therapeutic benefits in this setting. This case illustrates the need for further investigation into these less commonly addressed scenarios and treatment strategies that extend beyond current guidelines. |
| format | Article |
| id | doaj-art-c9497851684644b1867417507802dd91 |
| institution | Kabale University |
| issn | 2227-9059 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj-art-c9497851684644b1867417507802dd912025-01-24T13:24:22ZengMDPI AGBiomedicines2227-90592025-01-0113120110.3390/biomedicines13010201Expanded Use of Vorasidenib in Non-Enhancing Recurrent CNS WHO Grade 3 OligodendrogliomaAlexander S. Himstead0Jefferson W. Chen1Eleanor Chu2Mari A. Perez-Rosendahl3Michelle Zheng4Sherin Mathew5Carlen A. Yuen6Department of Neurological Surgery, University of California, Irvine, CA 92697, USADepartment of Neurological Surgery, University of California, Irvine, CA 92697, USADepartment of Radiological Sciences, University of California, Irvine, CA 92697, USADepartment of Pathology & Laboratory Medicine, University of California, Irvine, CA 92697, USAUC Irvine Charlie Dunlop School of Biological Sciences, University of California, Irvine, CA 92697, USADepartment of Research, University of California, Irvine, CA 92697, USADepartment of Neurology, Division of Neuro-Oncology, University of California, Irvine, CA 92697, USA<b>Background/Objectives</b>: Anaplastic oligodendrogliomas (AOs) are central nervous system (CNS) World Health Organization (WHO) grade 3 gliomas characterized by isocitrate dehydrogenase (IDH) mutation (m)IDH and 1p/19q codeletion. AOs are typically treated with surgery and chemoradiation. However, chemoradiation can cause detrimental late neurocognitive morbidities and an accelerated disease course. The recently regulatory-approved vorasidenib, a brain-penetrating oral inhibitor of IDH1/2, has altered the treatment paradigm for recurrent/residual non-enhancing surgically resected CNS WHO grade 2 mIDH gliomas. Though vorasidenib can delay the time to chemoradiation for grade 2 gliomas, the implications for vorasidenib in non-grade 2 mIDH gliomas are not well understood. <b>Results:</b> We present a case of a 71-year-old male with a grade 3 non-enhancing oligodendroglioma successfully treated with vorasidenib with an 11% reduction in residual tumor volume. Vorasidenib was well tolerated in our patient with a mild elevation in his liver transaminases that resolved following a brief interruption in treatment. <b>Conclusions:</b> Our case suggests that vorasidenib may impart therapeutic benefits in this setting. This case illustrates the need for further investigation into these less commonly addressed scenarios and treatment strategies that extend beyond current guidelines.https://www.mdpi.com/2227-9059/13/1/201vorasidenibanaplastic oligodendrogliomaisocitrate dehydrogenaseIDH inhibitorglioma |
| spellingShingle | Alexander S. Himstead Jefferson W. Chen Eleanor Chu Mari A. Perez-Rosendahl Michelle Zheng Sherin Mathew Carlen A. Yuen Expanded Use of Vorasidenib in Non-Enhancing Recurrent CNS WHO Grade 3 Oligodendroglioma Biomedicines vorasidenib anaplastic oligodendroglioma isocitrate dehydrogenase IDH inhibitor glioma |
| title | Expanded Use of Vorasidenib in Non-Enhancing Recurrent CNS WHO Grade 3 Oligodendroglioma |
| title_full | Expanded Use of Vorasidenib in Non-Enhancing Recurrent CNS WHO Grade 3 Oligodendroglioma |
| title_fullStr | Expanded Use of Vorasidenib in Non-Enhancing Recurrent CNS WHO Grade 3 Oligodendroglioma |
| title_full_unstemmed | Expanded Use of Vorasidenib in Non-Enhancing Recurrent CNS WHO Grade 3 Oligodendroglioma |
| title_short | Expanded Use of Vorasidenib in Non-Enhancing Recurrent CNS WHO Grade 3 Oligodendroglioma |
| title_sort | expanded use of vorasidenib in non enhancing recurrent cns who grade 3 oligodendroglioma |
| topic | vorasidenib anaplastic oligodendroglioma isocitrate dehydrogenase IDH inhibitor glioma |
| url | https://www.mdpi.com/2227-9059/13/1/201 |
| work_keys_str_mv | AT alexandershimstead expandeduseofvorasidenibinnonenhancingrecurrentcnswhograde3oligodendroglioma AT jeffersonwchen expandeduseofvorasidenibinnonenhancingrecurrentcnswhograde3oligodendroglioma AT eleanorchu expandeduseofvorasidenibinnonenhancingrecurrentcnswhograde3oligodendroglioma AT mariaperezrosendahl expandeduseofvorasidenibinnonenhancingrecurrentcnswhograde3oligodendroglioma AT michellezheng expandeduseofvorasidenibinnonenhancingrecurrentcnswhograde3oligodendroglioma AT sherinmathew expandeduseofvorasidenibinnonenhancingrecurrentcnswhograde3oligodendroglioma AT carlenayuen expandeduseofvorasidenibinnonenhancingrecurrentcnswhograde3oligodendroglioma |