Abstract
Simple SummaryDiffuse low-grade gliomas (LGG) are relatively uncommon primary brain cancers. In recent years, the molecular, diagnostic, and therapeutic approaches have evolved. IDH (isocitrate dehydrogenase) mutations can affect the great majority of these tumors with distinct genetic and clinical characteristics, carrying a more favorable prognosis compared with wild-type IDH. In patients with LGG, the most common manifestation is seizure and new neuroradiological tools are available to improve the diagnostic and therapeutic pathways. Surgical intervention is performed with the goal of maximum safe resection; postoperative chemoradiotherapy showed benefits in selected patients. New treatments based on molecular profiling, new small molecule and immunotherapy approaches could improve survival and quality of life. In this review, in order to identify the optimal clinical management of patients with LGG, we discuss the relevant biological and clinical characteristics, new therapeutic approaches, and future research directions for these tumors.Diffuse low-grade gliomas (LGG) represent a heterogeneous group of primary brain tumors arising from supporting glial cells and usually affecting young adults. Advances in the knowledge of molecular profile of these tumors, including mutations in the isocitrate dehydrogenase genes, or 1p/19q codeletion, and in neuroradiological techniques have contributed to the diagnosis, prognostic stratification, and follow-up of these tumors. Optimal post-operative management of LGG is still controversial, though radiation therapy and chemotherapy remain the optimal treatments after surgical resection in selected patients. In this review, we report the most important and recent research on clinical and molecular features, new neuroradiological techniques, the different therapeutic modalities, and new opportunities for personalized targeted therapy and supportive care.
Highlights
Diffuse low-grade gliomas (LLG) can be defined as tumors probably derived from glial cells and showing infiltrative growth and an absence of histological features of malignancy
An association between isocitrate dehydrogenase (IDH) status and amino acid Positron emission tomography (PET) parameters has been recently reported in low-grade gliomas (LGG), as the IDH-1/2 wild-type lesions have greater metabolic activity than IDH1/2 mutated lower-grade gliomas in terms of the SUVmax and SUV
Confirmed that patients with IDH mutated gliomas with or without 1p/19q codeletion benefited from the addition of PCV to radiotherapy, but suggested that patients with IDH wild-type astrocytomas may not benefit from this combination
Summary
Diffuse low-grade gliomas (LLG) can be defined as tumors probably derived from glial cells and showing infiltrative growth and an absence of histological features of malignancy. Magnetic resonance imaging (MRI) is the gold standard for the initial diagnosis of LGG; novel neuroradiological techniques, based on nuclear medicine, have been shown to contribute to the diagnosis and follow-up of these tumors. Due to their rarity and to the few prospective clinical trials, the optimal treatment of LGG remains controversial. We review the recent molecular, diagnostic, and therapeutic advances on LGG
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
