Contemporary Patterns of Care for Low-Grade Glioma in Australia and New Zealand.

IF 2.8 4区 医学 Q2 ONCOLOGY
Meghana Maddula, Nicholas McNamee, Hui K Gan, Laveniya Satgunaseelan, Eng-Siew Koh, Catherine H Han, Subotheni Thavaneswaran
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引用次数: 0

Abstract

Aim: The management of low-grade gliomas (LGGs) is evolving with new insights into disease biology. Furthermore, recently, the phase III INDIGO1 study highlighted the benefits of an IDH inhibitor, vorasidenib, in treating residual or recurrent grade 2 IDH-mutant gliomas following surgery alone. We aimed to characterise the current patterns of care for patients with LGGs in Australia and New Zealand, including the role of vorasidenib.

Methods: An online survey examining respondents' practice setting, caseload, and preferred treatment approach to three clinical scenarios was distributed through the Cooperative Trials Group for Neuro-Oncology, New Zealand Aotearoa Neuro-Oncology Society, and the Australian and New Zealand Society for Neuropathology in December 2023 with three reminders in April, June, and September of 2024.

Results: The survey response rate was 19.6% (57/291), 87.7% from Australia, and 12.3% from New Zealand, spanning medical oncology (45.7%), pathology (22.8%), radiation oncology (17.5%), and neurosurgery (14.0%). Case 1 examined an IDH-mutant grade 2 astrocytoma following gross total resection. Observation alone was recommended by 93%. Case 2 examined an incompletely resected IDH-mutant grade 2 astrocytoma. If feasible, 38% recommended further surgery and 83% adjuvant chemotherapy and radiotherapy. After 12 months of disease stability, 53% of the respondents preferred vorasidenib over the existing therapies. Case 3 examined an incompletely resected IDH-mutant grade 3 oligodendroglioma. No respondents recommended observation alone, with 26% recommending salvage surgery and 97% recommending further chemotherapy and radiotherapy.

Conclusions: This study describes current management practices for LGGs in Australia and New Zealand, showing ongoing variation and a cautious approach to integrating IDH inhibitors. This highlights the critical role of multidisciplinary team-based decision-making in increasingly complex clinical situations.

目的:低级别胶质瘤(LGG)的治疗正随着对疾病生物学的新认识而不断发展。此外,III期INDIGO1研究强调了IDH抑制剂vorasidenib在治疗单纯手术后残留或复发的2级IDH突变胶质瘤方面的优势。我们旨在了解澳大利亚和新西兰目前对LGGs患者的治疗模式,包括vorasidenib的作用:2023年12月,我们通过神经肿瘤学合作试验小组、新西兰奥特亚罗瓦神经肿瘤学学会以及澳大利亚和新西兰神经病理学学会发布了一项在线调查,调查内容包括受访者的执业环境、工作量以及对三种临床情景的首选治疗方法,并于2024年4月、6月和9月发出了三次提醒:调查回复率为 19.6%(57/291),其中 87.7% 来自澳大利亚,12.3% 来自新西兰,涉及肿瘤内科(45.7%)、病理科(22.8%)、肿瘤放射科(17.5%)和神经外科(14.0%)。病例 1 检查了一个 IDH 突变的 2 级星形细胞瘤,该瘤经过了大体全切除。93%的患者建议仅进行观察。病例 2 检查了一个未完全切除的 IDH 突变 2 级星形细胞瘤。如果可行,38%的人建议进一步手术,83%的人建议辅助化疗和放疗。在病情稳定12个月后,53%的受访者倾向于使用vorasidenib,而非现有疗法。病例3研究的是未完全切除的IDH突变3级少突胶质细胞瘤。没有受访者建议单纯观察,26%的受访者建议进行挽救性手术,97%的受访者建议进一步化疗和放疗:本研究描述了澳大利亚和新西兰目前对少突胶质细胞瘤的管理方法,显示出持续的差异和对整合IDH抑制剂的谨慎态度。这凸显了多学科团队决策在日益复杂的临床情况中的关键作用。
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来源期刊
Current oncology
Current oncology ONCOLOGY-
CiteScore
3.30
自引率
7.70%
发文量
664
审稿时长
1 months
期刊介绍: Current Oncology is a peer-reviewed, Canadian-based and internationally respected journal. Current Oncology represents a multidisciplinary medium encompassing health care workers in the field of cancer therapy in Canada to report upon and to review progress in the management of this disease. We encourage submissions from all fields of cancer medicine, including radiation oncology, surgical oncology, medical oncology, pediatric oncology, pathology, and cancer rehabilitation and survivorship. Articles published in the journal typically contain information that is relevant directly to clinical oncology practice, and have clear potential for application to the current or future practice of cancer medicine.
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