Treatment updates regarding anaplastic oligodendroglioma and anaplastic oligoastrocytoma

Anaplastic Oligodendroglioma / Anaplastic Oligoastrocytoma (AO/AOA) is a WHO Grade-III primary brain tumor. These tumors comprise about 5 - 10% of all gliomas, which make them the third most common primary brain tumors after glioblastoma multiforme and astrocytomas. For many years standard of treatment remained Maximum Safe Resection (MSR) followed by Radiotherapy (RT). These tumors have also been known to be sensitive to alkylator-based chemotherapy particularly the subset having 1p/19q co-deletion signature. There is robust data showing that these tumors are responsive to chemotherapy in recurrent or progressive setting. Recently, up front chemotherapy has been added to standard post-surgery RT. It has been found that subset of AO/AOA having 1p/19q co-deletion responded very well to the addition of chemotherapy. This substantial benefit in terms of median Overall Survival (OS) and median Progression Free Survival (PFS) have intrigued the personalized treatment of AO/AOA on the basis of molecular signature markers.