Citations 2
Prognostic and Predictive Effect of Age in Molecularly Defined Lower-Grade Gliomas
Minniti, Giuseppe, Brown, Paul D. , Vogelbaum, Michael A. , Ballman, Karla V. , Mercurio, Ann, Siegelin, Markus D., Tuohy, Kyle , Mansouri, Alireza , Simonelli, Matteo, DeStephano, David, Shuryak, Igor , Roy, Soumyajit , Hervey-Jumper, Shawn L., Horowitz, David P. , Sisti, Michael B. , Bruce, Jeffrey N. , Canoll, Peter, Neugut, Alfred I. , Iwamoto, Fabio M., Cheng, Simon K. , Kachnic, Lisa A. , Kinslow, Connor J , Brown, Paul D , Vogelbaum, Michael A , Ballman, Karla , Mercurio, Ann , Tuohy, Kyle , Mansouri, Alireza , Touat, Mehdi , Dehais, Caroline , Dipasquale, Angelo , Grinband, Jack , Yu, James B , Walch, Henry , Parker, Mitchell I , Shuryak, Igor , Roy, Soumyajit , Gallitto, Matthew , Horowitz, David P , McKhann, Guy M , Bruce, Jeffrey N , Ostrom, Quinn T , Neugut, Alfred I , Pike, Luke R G , Cheng, Simon K , Kachnic, Lisa A , Mehta, Minesh P , Wang, Tony J C , Minniti, Giuseppe , Siegelin, Markus D. , Kocakavuk, Emre , Ducray, François , Simonelli, Matteo , Yu, James B. , Hervey‐Jumper, Shawn L. , McKhann, Guy M. , Canoll, Peter , Ostrom, Quinn T. , Iwamoto, Fabio M., Mehta, Minesh P. , Wang, Tony J. C.
Journal of Clinical Oncology | August 12, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
PURPOSE Age ≥40 years is regarded as a high-risk feature and an indication for adjuvant chemoradiotherapy for patients with lower-grade glioma in clinical practice guidelines. It is unclear whether age remains a relevant prognostic factor for contemporary definitions of lower-grade gliomas in the molecular era. METHODS The Prospective Gliomas Research (PROGRES) database contains individual patient-level data from 11 prospective clinical trials or observational registries of histologically defined lower-grade 2-3 oligodendroglioma or astrocytoma. We determined the association of age (18-39 years v ≥40 years) with progression-free survival (PFS) stratified by isocitrate dehydrogenase 1 or 2 ( IDH1/2 ) status, using log-rank tests and Cox regression models. We validated our findings in a separate multi-institutional retrospective cohort (Retrospective Glioma Research [REGRES] database). RESULTS We identified 1,619 and 1,292 eligible patients in the PROGRES and REGRES cohorts, respectively. IDH -wildtype tumors were more common in patients 40 years and older (38% v 5%, odds ratio: 11.3 [95% CI, 6.5 to 19.7]). Age was associated with PFS in IDH -wildtype (5-year PFS for ≥40 v 18-39 years: 6% v 24%, hazard ratio [HR], 1.74 [95% CI, 1.21 to 2.50]) but not in IDH -mutant glioma (60% v 59%, HR, 0.89 [95% CI, 0.76 to 1.05], P interaction < .001). In IDH -wildtype tumors, older age predicted aggressive molecular features, including TERT promoter mutation (65% v 28%), EGFR amplification (41% v 15%), and chromosome +7/–10 alteration (57% v 25%). In a pooled analysis of four clinical trials, age was not predictive of a benefit from chemoradiotherapy versus radiotherapy alone for IDH -mutant glioma. CONCLUSION In the absence of additional clinical or molecular risk factors, age alone should not be considered an indication for administration or deferral of adjuvant treatment. Practice guidelines should be revised to reflect contemporary prognostic factors in the molecular era.
BRAF-altered glioma in adults and children: A Society for Neuro-Oncology (SNO) and European Society for Neuro-Oncology (EANO) consensus review on clinical management and future directions
Schreck, Karisa C, Fuente, Macarena I de la, Fat, Mary Jane Lim, Maas, S L, Levy, Jean M Mulcahy, Lombardi, G , Perrault, Sébastien, Petritsch, Claudia , Aldape, Kenneth, Chang, Susan M, Holdhoff, Matthias, Kazda, Tomas, Rhun, Emilie Le, Minniti, Giuseppe, Mueller, Sabine, Preusser, M, Smits, Marion, Weller, Michael, Wen, Patrick Y, Bent, Martin van den, Geurts, Marjolein, Lombardi, Giuseppe , Maas, Sybren L. N. , Schreck, Karisa C. , Levy, Jean M. Mulcahy , Chang, Susan M. , Duerinck, Johnny , Holdhoff, Matthias , Kazda, Tomáš , Rhun, Émilie Le , Minniti, Giuseppe , Mishra, Mark V. , Mueller, Sabine , Padovan, Marta , Preusser, Matthias , Smits, Marion , Weller, Michael , Bent, Martin J. van den , Geurts, Marjolein
Neuro-Oncology | June 5, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Oncogenic BRAF alterations occur in a subset of diffuse gliomas across WHO grades and are increasingly identified through modern molecular diagnostics. In addition to standard glioma therapies, targeted treatments are available for patients with BRAF-altered glioma supported by variable evidence spanning randomized trials, single-arm studies, and real-world evidence. This joint consensus review from the Society for Neuro-Oncology (SNO) and the European Association of Neuro-Oncology (EANO) synthesizes current knowledge on the diagnosis and management of BRAF-altered gliomas across age groups, tumor grades, and lines of therapy. Particular emphasis is placed on expert consensus in clinical scenarios where high-quality trial evidence remains limited. The review addresses rationale testing for BRAF alterations, selection, and monitoring of targeted therapies, management of treatment-related toxicities, approaches to resistance, and priorities for future research. It aims to provide practical, evidence-based guidance for clinicians while highlighting gaps to inform prospective studies.