Biology Over Monotherapy: Mature Results From European Organisation For Research and Treatment of Cancer 22033-26033 Reaffirm Molecular Stratification, Not Treatment Sequence, Defines Prognosis in Low-Grade Glioma
Mené sur 478 patients atteints d'un gliome de bas grade, cet essai randomisé de phase III compare l'efficacité, du point de vue de la survie sans progression et de la survie globale, de 2 traitements de première ligne, l'un par radiothérapie standard et l'autre par témozolomide
Determining optimal treatment selection and timing for patients with low-grade glioma (LGG) remains one of the most complex clinical decision frameworks in neuro-oncology. This challenge stems from a heterogeneous patient population with generally favorable prognosis requiring careful balance of optimizing therapeutic efficacy and long-term survivorship with minimization of treatment-related toxicity. In parallel, advances in the understanding of glioma biology over the past two decades have prompted successive iterations of the WHO classification of CNS tumors. The landmark 2016 WHO CNS classification formally incorporated molecular genetic features—including isocitrate dehydrogenase (IDH) mutation and 1p/19q codeletion status—officially ushering in the molecular era of glioma.1 The current 2021 WHO classification further leverages molecular stratification through integrated diagnostic criteria that define biologically and prognostically distinct subsets of LGG.2 This progress also introduces complexity in the interpretation of trials designed and conducted before the molecular era.
Journal of Clinical Oncology , éditorial en libre accès, 2026