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Peer-reviewedCC BYNeurotherapeutics

Current and emerging therapies in

  1. 1Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Corresponding author.
  2. 2Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
  3. 3Harvard Medical School, Boston, MA, USA; Center for Tumors of the Nervous System, Mass General Brigham Cancer Institute, Boston, MA, USA

Abstract

Isocitrate dehydrogenase ( IDH )-mutant gliomas constitute a distinct molecular subtype of diffuse gliomas, characterized by unique biology and relatively favorable clinical outcomes. However, despite their more indolent initial course, these tumors ultimately develop treatment resistance and remain incurable. Standard treatment approaches have relied on surgery followed by radiation and alkylating chemotherapy, which provide meaningful disease control but are associated with cumulative neurocognitive toxicities. The oral mutant IDH inhibitor vorasidenib recently became the first targeted therapy available for IDH -mutant glioma. Based on results of the randomized phase 3 INDIGO trial, vorasidenib was approved by the US Food and Drug Administration in 2024 as a first-line treatment option for grade 2 IDH -mutant glioma following surgery. In this review, we summarize the current therapeutic paradigm for IDH -mutant glioma, including the use of radiation and chemotherapy as well as the evolving role of mutant IDH-targeted therapy. We also highlight emerging therapeutic strategies, including approaches targeting key biologically informed vulnerabilities such as DNA damage repair pathways, cell-cycle and metabolic dependencies, tumor-associated hypermethylation, and anti-tumor immune activation. Collectively, these advances reflect a rapidly evolving treatment landscape driven by improved understanding of IDH biology, and hold promise to overcome therapeutic resistance and improve patient outcomes.

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BibTeX
@article{nakhate2026current,
  title = {{Current and emerging therapies in}},
  author = {Vihang Nakhate and Gilbert Youssef and Patrick Y. Wen},
  journal = {Neurotherapeutics},
  year = {2026},
  month = oct,
  doi = {10.1016/j.neurot.2026.e00913},
  url = {https://doi.org/10.1016/j.neurot.2026.e00913},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Current and emerging therapies in
AU  - Vihang Nakhate
AU  - Gilbert Youssef
AU  - Patrick Y. Wen
PY  - 2026
DA  - 2026/10/24
JO  - Neurotherapeutics
DO  - 10.1016/j.neurot.2026.e00913
UR  - https://doi.org/10.1016/j.neurot.2026.e00913
AB  - Isocitrate dehydrogenase ( IDH )-mutant gliomas constitute a distinct molecular subtype of diffuse gliomas, characterized by unique biology and relatively favorable clinical outcomes. However, despite their more indolent initial course, these tumors ultimately develop treatment resistance and remain incurable. Standard treatment approaches have relied on surgery followed by radiation and alkylating chemotherapy, which provide meaningful disease control but are associated with cumulative neurocognitive toxicities. The oral mutant IDH inhibitor vorasidenib recently became the first targeted therapy available for IDH -mutant glioma. Based on results of the randomized phase 3 INDIGO trial, vorasidenib was approved by the US Food and Drug Administration in 2024 as a first-line treatment option for grade 2 IDH -mutant glioma following surgery. In this review, we summarize the current therapeutic paradigm for IDH -mutant glioma, including the use of radiation and chemotherapy as well as the evolving role of mutant IDH-targeted therapy. We also highlight emerging therapeutic strategies, including approaches targeting key biologically informed vulnerabilities such as DNA damage repair pathways, cell-cycle and metabolic dependencies, tumor-associated hypermethylation, and anti-tumor immune activation. Collectively, these advances reflect a rapidly evolving treatment landscape driven by improved understanding of IDH biology, and hold promise to overcome therapeutic resistance and improve patient outcomes.
SN  - 1878-7479
SN  - 1933-7213
ER  -