In patients with gliomas bearing IDH1/2 mutations, the brain barrier-crossing oral drug vorasidenib kept tumors at bay, and could be used instead of more toxic chemotherapies and radiation. ASCO23
"What you just heard is a trial that was well done and well thought out: to use an oral, targeted, well-tolerated therapy to see if we could delay the use of our standard chemotherapy and radiation," commented ASCO expert Glenn Lesser, MD, from Wake Forest Baptist Health in Winston-Salem, North Carolina, the invited discussant at the briefing.
Adjuvant chemoradiotherapy has become the standard of care for patients with IDH-mutant grade 3 gliomas and patients with IDH-mutant grade 2 tumors who are thought to be a high risk for early progression. Patients were aged 12-80 years and had residual or recurrent grade 2 IDH1 or IDH2 mutated oligodendroglioma or astrocytoma, with measurable non-enhancing disease and no prior treatment for glioma . They were eligible for the study if they were not in immediate need of chemotherapy and/or radiation.
The primary endpoint was median PFS by blinded independent central review, which as noted above was 16.6 months longer in those on the drug compared with placebo.
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