RTOG 9802: radiation plus procarbazine, lomustine and vincristine in high-risk low-grade glioma
Adding PCV chemotherapy after radiotherapy for grade 2 glioma in adults who were over 40 or had residual tumour lengthened median survival from about eight to over thirteen years, one of the largest gains ever seen in neuro-oncology.
Overview
Phase 3 trial of 251 patients with grade 2 astrocytoma, oligodendroglioma or oligoastrocytoma who were either aged 40 or over or had undergone subtotal resection, randomised to radiotherapy alone or radiotherapy followed by six cycles of procarbazine, lomustine and vincristine (PCV).
Median overall survival was 13.3 years with PCV against 7.8 years with radiotherapy alone (hazard ratio 0.59), with benefit across histologies in later molecular analyses, strongest in IDH-mutant tumours.
- Median overall survival 13.3 vs 7.8 years; hazard ratio for death 0.59.
- Ten-year progression-free survival 51 percent vs 21 percent.
Radiotherapy followed by PCV is the standard for high-risk grade 2 IDH-mutant glioma; whether temozolomide can replace PCV, and whether vorasidenib can defer both, are the current questions.
- Small trial that took two decades to report.
- PCV toxicity limits completion of all six cycles.
Similar pages
not linked directly; found by shared links- Key paperEORTC 26951: adjuvant PCV after radiotherapy for anaplastic oligodendroglial tumours, long-term follow-up
Shares Procarbazine, Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, Vincristine.
- TrialEORTC 26951
Shares Procarbazine, Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, Vincristine.
- TrialRTOG 9402
Shares Procarbazine, Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, Vincristine.
- TrialEORTC 22033-26033
Shares Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, Astrocytoma, IDH-mutant (grades 2 to 4).
- TreatmentSafusidenib
Shares Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, Astrocytoma, IDH-mutant (grades 2 to 4).
- Key paperINDIGO: vorasidenib, the first targeted drug for IDH-mutant low-grade glioma
Shares Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, Astrocytoma, IDH-mutant (grades 2 to 4), New England Journal of Medicine.
- TrialINDIGO
Shares Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, Astrocytoma, IDH-mutant (grades 2 to 4).
- TermExtent of resection (RANO resect classes)
Shares Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, Astrocytoma, IDH-mutant (grades 2 to 4).