Oligodendroglial Tumor

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2021-01-23

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Drugs

(S)-perillyl alcohol temozolomide, 1,2:5,6-Dianhydrogalactitol, 18-(p-[124I]-iodophenyl)octadecyl phosphocholine

(S)-perillyl alcohol temozolomide, 1,2:5,6-Dianhydrogalactitol, 18-(p-[124I]-iodophenyl)octadecyl phosphocholine, 2-hydroxyoleic acid, 4,6,8-trihydroxy-10-(3,7,11-trimethyldodeca-2,6,10-trienyl)-5,10-dihydrodibenzo[b,e][1,4] diazepin-11-one, 4-[123I] iodo-L-phenylalanine, 4-[131I] iodo-L-phenylalanine, 5-aminolevulinic acid hydrochloride ( GLEOLAN, GLIOLAN ), 7-beta-hydroxycholesteryl-3-beta-oleate, Adenoviral vector serotype 5 encoding the human interleukin-12 p70 transgene, Adenovirus serotype 5 containing partial E1A deletion and an integrin-binding domain, Adenovirus-associated vector containing human Fas-c gene, Adenovirus-mediated Herpes Simplex Virus-thymidine kinase (HKSV-tk) gene ( CEREPRO ), Allogeneic and autologous haptenised and irradiated cells and cell lysates derived from glioma, Asunercept, Autologous Tumor-Derived gp96 Heat Shock Protein-Peptide Complex ( ONCOPHAGE ), Autologous dendritic cells pulsed with RNA from glioma stem cells, Autologous dendritic cells pulsed with autologous cell lysate, Autologous dendritic cells pulsed with tumour antigen-derived synthetic peptides (MAGE-1, HER-2, AIM-2, TRP-2, gp-100, and interleukin-13 receptor alpha), Autologous ex-vivo-expanded leucocytes treated with 5-aza-2'-deoxycytidine, Autologous glioma tumour cells treated with antisense molecule directed against the insulin-like growth factor type 1 receptor, Bevacizumab ( Equidacent, AVASTIN, Aybintio, MVASI ), Biotinylated anti-tenascin monoclonal antibody for use with 90-Yttrium, Boswellia serrata resin dry extract, Cannabidiol ( EPIDIOLEX, EPIDYOLEX ), Carmustine ( GLIADEL, BICNU, CARMUSTINE OBVIUS ), Carmustine (solution for intratumoral injection), Cilengitide, Combination of carboplatin and sodium valproate, Delta-9-tetrahydrocannabinol and cannabidiol from extracts of the Cannabis sativa L. plant, Doxorubicin (administered after synthetic double-stranded siRNA oligonucleotide directed against claudin-5 complexed with polyethyleneimine), Doxorubicin hydrochloride (drug eluting beads), Dronabinol and cannabidiol, Eflornithine, Enzastaurin hydrochloride, Erlotinib hydrochloride ( TARCEVA ), Florilglutamic acid (18F), Fluciclovine (18F), Flucytosine ( ANCOTIL ), Gadodiamide (liposomal), Galunisertib, Gimatecan, Glutathione-pegylated liposomal doxorubicin hydrochloride, H-Arg-Pro-Lys-Pro-Gln-Gln-Phe-2Thi-Gly-Leu-Met(O2)-NH2-DOTA-213-bismuth, H-Arg-Pro-Lys-Pro-Gln-Gln-Phe-2Thi-Gly-Leu-Met(O2)-NH2-DOTA-225-Actinium, Herpes simplex virus lacking infected cell protein 34.5, Human transferrin conjugated to mutant diphtheria toxin, Humanised monoclonal antibody against epidermal growth factor receptor, Humanised recombinant monoclonal antibody against epidermal growth factor receptor conjugated to maleimidocaproyl monomethylauristatin F, IL-12-secreting dendritic cells, loaded with autologous tumour lysate, Iodine (131I) anti-nucleohistone H1 chimeric biotinylated monoclonal antibody, Iodine (131I) anti-tenascin monoclonal antibody 81C6, Iodine (131I) chlorotoxin, Irinotecan hydrochloride (drug eluting beads), L-cysteine, L-leucyl-L-alpha-glutamyl-L-alpha-glutamyl-L-lysyl-L-lysylglycyl-L-asparaginyl-L-tyrosyl-L-valyl-L-valyl-L-threonyl-L-alpha-aspartyl-L-histidyl-S-[1-[(4-carboxycyclohexyl)methyl]-2,5-dioxo-3-pyrrolidinyl]-complex with keyhole limpet haemocyanin, Larotrectinib ( VITRAKVI ), Marizomib, N-(4-Methoxyphenyl)-N,2,6-trimethylfuro[2,3-d]pyrimidin-4-amine, Nimotuzumab ( THERALOC ), Oligonucleotide phosphorothioate (TAAACGTTATAACGTTATGACGTCAT), Onfekafusp alfa, Paclitaxel-succinate-Arg-Arg-Leu-Ser-Tyr-Ser-Arg-Arg-Arg-Phe, Picropodophyllin, Pritumumab, Pseudomonas exotoxin (domains II/III)-Interleukin 13 chimeric protein, Recombinant fusion protein of circulary-permuted IL-4 and pseudomonas exotoxin A, [IL-4(38-37)-PE38KDEL], Recombinant human bone morphogenetic protein 4, Regorafenib ( STIVARGA ), Salmonella typhi Ty21a strain transfected with a plasmid vector encoding the human vascular endothelial growth factor receptor 2, Synthetic double-stranded siRNA oligonucleotide directed against claudin-5 complexed with polyethyleneimine (prior to administration of doxorubicin), Talampanel, Technetium (99mTc) tetrofosmin, Temozolomide ( TEMODAL, TEMODAR ), Topotecan hydrochloride (liposomal), Trabedersen, Tranilast, Veledimex, Vocimagene amiretrorepvec, Zoledronic acid, Zotiraciclib

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Oligodendrogliomas are cerebral tumors that are differentiated from other gliomas on the basis of their unique genetic characteristics and better response to chemotherapy. These tumors are classified according to their grade (low grade oligodendrogliomas: grade II of the WHO classification and anaplastic oligodendrogliomas: grade III of the WHO classification) and according to their pure or mixed histology (oligoastrocytomas).

Epidemiology

Until now, the incidence of these tumors has been largely underestimated. Oligodendrogliomas may represent up to 30% of all adult gliomas. Annual incidence can therefore be estimated at around one new case per 100,000 individuals per year. Prevalence is estimated at 1/300,000.

Clinical description

Low grade tumors are usually diagnosed after a prolonged history of seizures and headaches. Clinical presentation of malignant forms is usually more acute with rapidly progressive neurological deficits and signs of intracranial hypertension (headaches and vomiting). Malignant forms can arise from transformation of a benign tumor several years after its diagnosis. These tumors may develop anywhere in the central nervous system but arise most frequently in the cerebral hemispheres.

Etiology

The etiology is not known but no hereditary forms of oligodendroglioma have been reported. However, specific genetic characteristics, such as loss of chromosomes 1p and 19q, are observed.

Diagnostic methods

MRI may reveal infiltration of the brain parenchyma. Enhancement after contrast injection is indicative of an aggressive and malignant oligodendroglioma.

Differential diagnosis

The differential diagnosis should include low grade astrocytomas (see this term).

Management and treatment

Treatment starts with surgery. Radiotherapy is mandatory for malignant tumors, regardless of the extent of the surgical resection. Chemotherapy is beneficial and is often used during treatment of the initial tumor and for treatment of a recurring malignant oligodendroglioma. In the case of low grade partially resected tumors, chemotherapy now tends to replace radiotherapy as thefirst-line treatment. Management requires a multidisciplinary team with experience in neuro-oncology. The treatment protocol should follow the recommendations resulting from prospective studies.

Prognosis

The prognosis is usually better than that for other gliomas, such as astrocytomas. As a result of combined treatment with surgery, chemotherapy and radiotherapy, survival rates in patients without recurrence are also good, even for patients with malignant (anaplastic) tumors.