Isocitrate dehydrogenase mutations in brain tumors: overview and approache to treatment

The classification of isocitrate dehydrogenase (IDH)-mutant glioma has taken on significant importance in the last decade and a half. Changes in glioma classification of the World Health Organization in 2016 and further in 2021 reflect the significance of the IDH mutation status regarding tumor biology and expected prognosis and provide a substrate for new treatment approaches to IDH-mutant gliomas that were not considered until recently. IDH mutation status has proven to be important as a diagnostic criterion, a prognostic indicator, and as a therapeutic target which allows personalized biologic and immunologic treatments. Patient outcomes have been improved, and the deferral of chemo- and radiation therapies delays the onset of potentially debilitating clinical and neurologic toxic effects. Paradigm-shifting results in recent clinical trials provide new therapy options and have changed the standard of care for the treatment of IDH-mutant glioma.