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Published on: January 19, 2024
Thirty years of progress in the management of low-grade gliomas
1Brain Tumor Center, ErasmusMC Cancer Institute, ErasmusMC University Medical Center, Doctor Molenwaterplein, 40, 3015GD Rotterdam, The Netherlands.
Abstract:
This paper reviews 30 years of developments in the area of low-grade gliomas. This includes the changes in diagnostics with the incorporation of 1p/19q and IDH mutations in the diagnostic classifier, the improved surgical techniques, improved delivery of radiotherapy and chemotherapy. More recently, the better understanding of the altered cellular processes has lead to the development of novel drugs that may alter completely alter the management of patients early in the course of their disease.
Insights
This review covers 30 years of low-grade glioma management advancements. Key developments include diagnostic updates, surgical improvements, and novel therapies targeting cellular processes for better patient outcomes.
Area of Science:
- Neuro-oncology
- Molecular diagnostics
- Cancer therapy
Background:
- Low-grade gliomas represent a significant challenge in neuro-oncology.
- Historically, management has relied on conventional treatments with variable efficacy.
- Advances in understanding glioma biology are crucial for therapeutic progress.
Purpose of the Study:
- To provide a comprehensive review of low-grade glioma (LGG) management over the past three decades.
- To highlight key advancements in diagnostics, surgical techniques, and adjuvant therapies.
- To discuss the impact of recent molecular discoveries on future treatment strategies.
Main Methods:
- Literature review of studies published over the last 30 years focusing on low-grade gliomas.
- Analysis of diagnostic criteria evolution, including molecular markers.
- Examination of surgical, radiotherapeutic, and chemotherapeutic advancements.
- Review of emerging targeted therapies based on cellular pathway understanding.
Main Results:
- Diagnostic classification of LGGs has been revolutionized by incorporating 1p/19q codeletion and IDH mutations.
- Surgical techniques have advanced, improving resection rates and patient safety.
- Radiotherapy and chemotherapy delivery have become more precise and effective.
- Emerging targeted therapies show promise in altering the disease course early.
Conclusions:
- The management of low-grade gliomas has significantly evolved over 30 years, driven by diagnostic and therapeutic innovations.
- Molecular profiling is now central to accurate diagnosis and personalized treatment selection.
- Continued research into cellular processes will likely yield novel therapeutic agents, potentially transforming early-stage disease management.
