Roth Patrick, Capper David, Calabrese Evan, Halasz Lia M, Jakola Asgeir S
University of Zurich, Zurich, Switzerland.
Department of Neurology and Brain Tumor Center, University Hospital Zurich, Zurich, Switzerland.
Neurooncol Pract. 2024 Dec 4;12(Suppl 1):i29-i37. doi: 10.1093/nop/npae100. eCollection 2025 Feb.
Isocitrate dehydrogenase (IDH)-mutant gliomas, comprising both astrocytomas and oligodendrogliomas, represent a distinct group of tumors that pose an interdisciplinary challenge. Addressing the needs of affected patients requires close collaboration among various disciplines, including neuropathology, neuroradiology, neurosurgery, radiation oncology, neurology, medical oncology, and other relevant specialties when necessary. Interdisciplinary tumor boards are central in determining the ideal diagnostic and therapeutic strategies for these patients. The key tasks of a tumor board include the evaluation of imaging findings, selecting the appropriate surgical approach, discussing additional treatment options, and identification/determination of tumor recurrence and progression. In addition to established treatments such as radiotherapy and alkylating chemotherapy, patients with an isocitrate dehydrogenase (IDH)-mutant glioma for whom additional treatment is indicated may now also have the option of receiving treatment with an mutant isocitrate dehydrogenase inhibitor such as vorasidenib or ivosidenib. In this regard, the collaborative nature of tumor boards becomes even more crucial for evaluating comprehensively the needs of these patients. Through interdisciplinary discussions, tumor boards aim to develop personalized treatment strategies that maximize therapeutic efficacy while minimizing potential side effects and preserving patients' quality of life.
异柠檬酸脱氢酶(IDH)突变型胶质瘤,包括星形细胞瘤和少突胶质细胞瘤,是一类独特的肿瘤,带来了跨学科挑战。满足受影响患者的需求需要多学科密切合作,包括神经病理学、神经放射学、神经外科、放射肿瘤学、神经病学、医学肿瘤学以及必要时的其他相关专业。跨学科肿瘤委员会对于确定这些患者的理想诊断和治疗策略至关重要。肿瘤委员会的关键任务包括评估影像学检查结果、选择合适的手术入路、讨论其他治疗方案以及识别/确定肿瘤复发和进展。除了放疗和烷化剂化疗等既定治疗方法外,对于有额外治疗指征的异柠檬酸脱氢酶(IDH)突变型胶质瘤患者,现在也可以选择接受突变型异柠檬酸脱氢酶抑制剂(如沃拉西尼或艾伏尼布)治疗。在这方面,肿瘤委员会的协作性质对于全面评估这些患者的需求变得更加关键。通过跨学科讨论,肿瘤委员会旨在制定个性化治疗策略,在最大限度提高治疗效果的同时,尽量减少潜在副作用并维持患者的生活质量。
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