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Purpose <p>IDH-wt diffuse gliomas with histologic grade 2–3 features and distinct molecular characteristics are now classified as molecular glioblastoma, yet outcomes and optimal management remain incompletely defined in a contemporary cohort.</p> Methods <p>Adults with histologic grade 2–3 IDH-wt gliomas diagnosed from 1996 to 2019 were retrospectively identified. Overall survival (OS) and progression-free survival (PFS) were estimated using Kaplan-Meier methods, with Cox regression used to assess prognostic factors. To account for noncanonical IDH mutations, subgroup analyses were performed in those age &gt; 55 or with next generation sequence (NGS) IDH testing.</p> Results <p>A total of 134 patients were included, with a median follow-up of 29.8 months. Median OS was 35 months (95% CI: 28.8–43), and median PFS was 20.9 months (95% CI: 14.5–27.4). Grade 2 tumors demonstrated significantly improved outcomes compared to grade 3 tumors (median OS 94.5 vs. 29.8 months; median PFS 50.6 vs. 15.3 months). Among grade 3 tumors, sequential radiation and chemotherapy yielded a median OS of 29.8 months versus 29.8 months with concurrent chemoradiation followed by chemotherapy (<i>p</i> = 0.17); median PFS was 22.2 months versus.</p> Conclusion <p>IDH-wt gliomas with grade 2-3 histology have heterogeneous outcomes. Grade 3 tumors show survival comparable to molecular glioblastoma, while a subset of grade 2 tumors exhibit prolonged survival. Concurrent chemoradiation did not confer a survival advantage over sequential therapy in grade 3 tumors, supporting reevaluation of treatment intensity in selected patients.</p>

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Long-term outcomes in IDH-wildtype (IDH-wt) gliomas with historical WHO grade 2 and 3 histology

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月23日

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  • Patrick P. Carriere,
  • Ory Haisraely,
  • Ashley Aaroe,
  • Kayode Ahmed,
  • Ryan Lewis,
  • Darien Colson-Fearon,
  • McArthur Bolden,
  • Todd A. Swanson,
  • Thomas H. Beckham,
  • Chenyang Wang,
  • Brian De,
  • Subha Perni,
  • Martin C. Tom,
  • Jing Li,
  • Susan McGovern,
  • Mary F. McAleer,
  • Amol Ghia,
  • Wen Jiang,
  • Caroline Chung,
  • David Grosshans,
  • Leomar Ballester,
  • Yoshua Esquenazi,
  • Carlos Kamiya-Matsuoka,
  • Debra Nana Yeboa

摘要

Purpose

IDH-wt diffuse gliomas with histologic grade 2–3 features and distinct molecular characteristics are now classified as molecular glioblastoma, yet outcomes and optimal management remain incompletely defined in a contemporary cohort.

Methods

Adults with histologic grade 2–3 IDH-wt gliomas diagnosed from 1996 to 2019 were retrospectively identified. Overall survival (OS) and progression-free survival (PFS) were estimated using Kaplan-Meier methods, with Cox regression used to assess prognostic factors. To account for noncanonical IDH mutations, subgroup analyses were performed in those age > 55 or with next generation sequence (NGS) IDH testing.

Results

A total of 134 patients were included, with a median follow-up of 29.8 months. Median OS was 35 months (95% CI: 28.8–43), and median PFS was 20.9 months (95% CI: 14.5–27.4). Grade 2 tumors demonstrated significantly improved outcomes compared to grade 3 tumors (median OS 94.5 vs. 29.8 months; median PFS 50.6 vs. 15.3 months). Among grade 3 tumors, sequential radiation and chemotherapy yielded a median OS of 29.8 months versus 29.8 months with concurrent chemoradiation followed by chemotherapy (p = 0.17); median PFS was 22.2 months versus.

Conclusion

IDH-wt gliomas with grade 2-3 histology have heterogeneous outcomes. Grade 3 tumors show survival comparable to molecular glioblastoma, while a subset of grade 2 tumors exhibit prolonged survival. Concurrent chemoradiation did not confer a survival advantage over sequential therapy in grade 3 tumors, supporting reevaluation of treatment intensity in selected patients.