First Mexican consensus guideline for the management of IDH-mutant low-grade gliomas: Mexican guidelines for IDH-mutant gliomas

The objective of the study is to propose a diagnostic and therapeutic algorithm for patients with mIDH-LGG tailored to our country's healthcare setting.Patients with isocitrate dehydrogenase-mutant (mIDH) low-grade gliomas (LGGs) demand a multidisciplinary approach.Individualized management should consider local resources, patient preferences, clinical features, imaging results, and tumor pathological characteristics.We use a multidisciplinary team of neuro-oncologists, medical oncologists, neurosurgeons, radiation oncologists, neuroimaging specialists, geneticists, and neuropathologists collaborated to develop a manuscript through a Delphi consensus method.Diagnosis includes a complete clinical examination, neuroimaging, histopathological tissue examination, and molecular analysis.Treatment options include (a) surgery as the first-line approach, aiming for maximal safe resection; (b) radiation therapy, administered postoperatively or as a primary treatment in selected cases; (c) systemic therapy; and (d) palliative care for patients with advanced disease or limited therapeutic options.For asymptomatic, slow-growing tumors or elderly patients, an appropriate strategy of active surveillance might be considered.We present custom-made diagnostic and therapeutic algorithms for Mexican patients with mIDH-LGG.To optimize treatment outcomes, participation in clinical trials and early referral to specialized centers are encouraged.