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Updated: Jun 9, 2026
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A Protocol for Explant Cultures of IDH1-mutant Diffuse Low-grade Gliomas
Published on: May 9, 2025
Contemporary practice patterns in IDH-mutant glioma management: a multidisciplinary multi-institutional survey
Tyler A Lanman1, L Nicolas Gonzalez Castro2,3,4, Haley K Perlow5
1Department of Neurology, University of Washington, 1959 NE Pacific St., Seattle, WA, 98195, USA.
Journal of Neuro-Oncology
|June 8, 2026
Summary
Clinician approaches to IDH-mutant glioma management vary significantly. Radiation oncologists are less likely to recommend IDH inhibitors (IDHi) compared to neuro/medical oncologists, highlighting the need for consensus.
Area of Science:
- Neuro-oncology
- Clinical Decision-Making
- Glioma Treatment
Background:
- Management of IDH-mutant glioma is evolving rapidly.
- The 2024 FDA approval of vorasidenib (a mutant IDH inhibitor) presents new treatment options.
- Optimal treatment strategies for specific clinical scenarios remain unclear.
Purpose of the Study:
- To understand how clinicians approach IDH-mutant glioma management.
- To evaluate the influence of demographic and professional backgrounds on treatment decisions.
- To identify variations in clinical practice for IDH-mutant glioma.
Main Methods:
- A survey was distributed to neuro-oncologists, medical oncologists, radiation oncologists, and neurosurgeons.
- The survey included demographic questions and 10-13 case-based clinical scenarios.
- Responses were compared between specialties, and univariable regression identified predictors of treatment preference.
Main Results:
- 153 clinicians completed the survey, revealing heterogeneity in treatment recommendations.
- Radiation oncologists were less likely to recommend IDH inhibitors (IDHi) and more likely to recommend radiotherapy or chemoradiotherapy.
- Familiarity and enthusiasm for IDHi varied significantly across specialties.
Conclusions:
- Substantial variation exists in the real-world management of IDH-mutant glioma.
- Certain clinical scenarios show consensus, while others indicate uncertainty.
- There is a need for multidisciplinary collaboration and evidence-based consensus to guide clinical decisions.
