Concept and Optimal Treatments of Malignant Gliomas

Abstract

  Diffuse gliomas account for approximately 80% of malignant central nervous system tumors and are classified by the World Health Organization (WHO) into grades Ⅱ-Ⅳ according to their histopathology and clinical behavior. WHO grade Ⅱ diffuse gliomas used to be referred to as low-grade gliomas (LGGs), while WHO grades Ⅲ and Ⅳ gliomas were high-grade gliomas. LGGs are generally less aggressive tumors with a longer and indolent clinical course. Adding radiotherapy to surgery has been suggested for LGG. LGGs are responsive to radiotherapy plus chemotherapy. However, the timing of these therapies after surgery is controversial. On the other hand, several mutant IDH1 inhibitors have been clinically investigated. The mutant IDH1 inhibitors could be a promising option to suppress clonal evolutions and prolong the malignant transformation-free survival.