David A. Reardon, MD

Panelists discuss how they evaluate patients postsurgically by weighing factors like tumor location, extent of resection, patient age, and quality of life considerations to determine whether to pursue immediate treatment or surveillance, while emphasizing that microscopic disease always remains despite apparent gross total resection.

Panelists discuss how they perform comprehensive molecular testing using immunohistochemistry, FISH, and next-generation sequencing to identify IDH mutations and other critical markers like CDKN2A/2B loss that guide treatment decisions and tumor classification.

Panelists discuss how they approach the treatment journey by prioritizing early IDH mutation detection, coordinating multidisciplinary teams for maximal safe resection, and utilizing advanced surgical techniques to optimize outcomes while preserving neurologic function.

Panelists discuss how the 2021 WHO classification has fundamentally shifted glioma diagnosis from histologic appearance to molecular markers, particularly IDH mutation status, which now determines treatment strategies and prognosis.

Malignant glioma, the mostcommon primary centralnervous system (CNS) tumorin adults, remains one of the greatesttherapeutic challenges in oncologytoday due to the limited impact ofconventional cytotoxic therapies onoverall survival for patients with thesetumors. Although surgery and external-beam radiotherapy (XRT) can prolongsurvival, the value of adjuvantchemotherapy has been negligible formost malignant glioma patients. Theexception has been those patients withanaplastic oligodendroglioma and accompanyingchromosomal 1p and 19qloss-a fairly uncommon subset ofmalignant glioma patients who respondvery favorably to alkylatorbasedchemotherapy.[1]