“In approximately 80% of grade 2 gliomas there are mutations in the Idh1 gene against which there is a targeted therapy, vorasidenib, capable of doubling survival from the disease as demonstrated by the Indigo study published in the ‘New England Journal of Medicine ‘”. This was explained by Andrea Pace, head of Neuro-oncology at the Irccs Regina Elena Tumor Institute in Rome, today in Rome during a media tutorial on the most advanced frontier of precision oncology, focused on the oncogenic role of Idh mutations and created with the contribution not influencing the Servier Group in Italy.
“Gliomas are a form of brain tumor and every year, in Italy, around 3 thousand new cases are recorded – underlines Pace – 20% are made up of grade 2 gliomas, i.e. low grade, which are more frequent in young people among between the ages of 20 and 40. Symptoms at onset usually consist of epileptic seizures, often resistant to treatment, because the diseased cells tend to infiltrate healthy nervous tissue. These brain tumors grow slowly, but over the years they can become high-grade and, therefore, more aggressive.” Surgery with maximum possible removal of the tumor is the treatment of choice, followed, even for years, by observation of the disease, and then moving on to chemotherapy and radiotherapy if the tumor becomes more aggressive. “These patients can live with the disease for decades, continuing to work, be active in life and have children – specifies Pace – For 20 years the therapies following surgery have remained identical, consisting of chemotherapy and radiotherapy. Today the change is radical, because neuro-oncology can also benefit from precision medicine. In fact, molecular analysis has made it possible to highlight the presence of genetic mutations even in brain tumors. In particular, Idh1 mutations are present in 80% of cases grade 2 gliomas, those of Idh2 in approximately 5%. When the Idh1 protein is mutated, it initiates the tumor growth mechanism and it has been shown that it can be the target of targeted therapies.”
The Indigo study involved approximately 330 patients with non-aggressive grade 2 gliomas who had undergone surgery but not chemotherapy or radiotherapy. “Vorasidenib, an Idh inhibitor, more than doubled progression-free survival compared to observation alone: 27.7 months compared to 11.1. It is essential, as established by the WHO classification, that in each patient, at the moment of the diagnosis, molecular analysis is performed”, he concludes.
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