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Diffuse gliomas, including low-grade gliomas (LGG) and glioblastomas (GBMs), are a class of malignant brain tumors.
-level glioma to high-level glioma is usually associated with the degree to which tumor-enhanced MRI imaging is enhanced.
isochloric acid dehydrogenase (IDH) mutation is found in 70% of LGG.
Ivosidenib is an inhibitor of IDH mutant (mIDH) solid tumors.
authors conducted a multi-center, open-labeled, dose-incremental, expanded clinical phase I study of ivosidenib's treatment of mIDH glioma.
patients take ivosidenib oral every day for 28 days for a cycle.
, ivosidenib was found to reduce the volume and growth rate of unencumbmented tumors on MRI imaging.
results were published online June 2020 in Journal of Clinical Oncology.
research method IDH mutant glioma is a separate solid glioma with unique molecular pathogenesis.
IDH mutations in gliomas occur in the early stages of tumor development and are concentrated in arginine-key residues at enzyme active points, associated with unique patterns of higher levels of methylation of DNA and persist throughout the disease process.
the IDH mutant glioma had a better prognosis compared with IDH wild glioma with the same WHO rating.
in 66 patients with progressing gliomas, ivosidenib was well-resistant and no dose-restricted toxicity was found.
19.7% of the adverse reactions in the 3rd grade, of which only 3% were related to treatment.
of 35 non-enhanced gliomas was 2.9%, and 1 case was partially alleviated.
30 (85.7%) of the 35 patients were in stable condition.
31 cases with reinforced glioma, 14 (45.2%) were stable.
the medium progression-free survival of patients with no strengthening and enhanced glioma was 13.6 months (95% CI, 9.2-33.2 months) and 1.4 months (95% CI, 1.0-1.9 months), respectively.
results, the researchers quantified tumor volume in 24 patients without fortified glioma before and during ivosidenib treatment.
results suggest that the tumor growth rate is 26% (95% CI, 9%-46%) every 6 months before ivosidenib and 9% (95% CI, 1% -20%) after ivosidenib.
the following are 4 typical cases: 1 case 1, patients with mesodynatic glioma, 3 years after surgery, radiotherapy and terpene amine treatment, in MRI-T2 and FLAR sequence imaging of abnormal signal lesions of slow growth.
the use of ivosidenib, MRI imaging and volume growth curves showed tumor shrinkage (Figure 1A).
2 cases of 2, asstaryctic cell tumor patients, 6 years ago had a tumor excision, and then did not carry out auxiliary treatment.
follow-up suggested an increase in tumor volume, and after ivosidenib therapy, MRI imaging and volume growth curves showed tumor shrinkage (Figure 1B).
3 cases 3, less sudden glioma patients, 4 years ago surgical excision, after surgery did not carry out auxiliary treatment.
found that the tumor had relapsed, ivosidenib was used and the tumor shrunk in size (Figure 1C).
4 cases 4, the patient 8 years ago biopsy was diagnosed with a rare glioma, after surgery and taking temoxamine for 1 year, and then no other treatment;
1. 4 patients without reinforced glioma, MRI imaging and tumor volume growth curve before and after ivosidenib treatment.
conclusions, the results confirm that ivosidenib inhibits unencumved IDH mutant gliomas more than fortified gliomas;
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