Surgery of IDH-mutated grade 2 glioma: continually setting the bar higher

Over the last twenty years, major advances have been achieved in the management of patients diagnosed with an isocitrate dehydrogenase (IDH)-mutated grade 2 glioma. Two randomized trials provided important data. First, long-term survival was demonstrated to be significantly improved (13.3 versus 7.8 years) by adding chemotherapy (procarbazine—CCNU–vincristine) to radiation therapy.1 Second, the short-term progression free survival was found to be much longer in the arm treated by vorasidenib (a new well-tolerated drug targeting IDH-mutation) rather than placebo.