Service de Neuro-oncologie, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, AP-HP, Sorbonne Université.
Institut du Cerveau, Paris Brain Institute (ICM), Inserm, CNRS, Sorbonne Université, AP-HP, SIRIC CURAMUS, Paris, France.
Curr Opin Neurol. 2024 Dec 1;37(6):708-716. doi: 10.1097/WCO.0000000000001316. Epub 2024 Sep 11.
PURPOSE OF REVIEW: Isocitrate dehydrogenase (IDH) mutation is a defining molecular driver of WHO grade 2-4 astrocytomas and oligodendrogliomas. In this article, we review the recent therapeutic approaches specifically targeting IDH-mutant gliomas and summarize ongoing clinical trials in this population. RECENT FINDINGS: The IDH inhibitor vorasidenib recently demonstrated its efficacy after surgical resection in grade 2 IDH-mutated gliomas. Several studies in patients with IDH-mutant gliomas are currently exploring various strategies to target IDH mutations, including the use of small-molecule inhibitors, immunotherapies, peptide vaccines and agents targeting metabolic and epigenomic vulnerabilities. SUMMARY: Mutant-IDH targeting holds significant promise in treating progressive or recurrent IDH-mutant gliomas. Recent results with IDH inhibitors will change practice and influence the existing guidelines in a near future.
目的综述:异柠檬酸脱氢酶(IDH)突变是世界卫生组织(WHO)分级 2-4 级星形细胞瘤和少突胶质细胞瘤的明确分子驱动因素。本文综述了专门针对 IDH 突变型神经胶质瘤的最新治疗方法,并总结了该人群中正在进行的临床试验。
最近的发现:IDH 抑制剂ivosidenib 在手术后的 2 级 IDH 突变型神经胶质瘤中显示出疗效。目前有几项针对 IDH 突变型神经胶质瘤患者的研究正在探索针对 IDH 突变的各种策略,包括使用小分子抑制剂、免疫疗法、肽疫苗和针对代谢和表观遗传脆弱性的药物。
总结:靶向突变 IDH 对治疗进行性或复发性 IDH 突变型神经胶质瘤具有重要意义。最近 IDH 抑制剂的结果将在不久的将来改变实践并影响现有的指南。
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