Vorasidenib: A promising therapeutic breakthrough for diffuse isocitrate dehydrogenase mutant gliomas.

Abstract

The most common type of major malignant tumor of the brain includes gliomas, which are marked by diffuse invasion of malignant cells in the brain. Grade II and grade III diffuse gliomas classi fi ed by the World health organization (WHO) are also known as lower-grade gliomas LLG. These tumors are seen more frequently in younger people, show a slower growth rate, and mostly does not appear on contrast enhancement on T1-weighted brain MRI in the beginning. Current treatment includes chemotherapy, radiation, and maximally safe tumor resection. However, there is a high chance of recurrence and transformation of LLG into a more aggressive tumor. The advanced treatment outlook is to attack mutant genetic changes that are causing gliomas in the initial stage to minimize the use of harmful therapies and to hinder its progression to a higher tumor grade. 1 Isocitrate dehydrogenase (IDH), is an important enzyme having a major role in the tricarboxylic cycle as well as controlling the redox cofactor in between mitochondria and cytosol. IDH1, IDH2, and IDH3 are the three existing isoforms. 2 Mutations in isoforms of IDH1 and IDH2, that are heterozygous lead to the formation of oncogenic d-2-hy-droxyglutarate (2-HG), 3 causing different malignant growth counting