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  • Updated 06.22.2021
  • Released 01.16.2020
  • Expires For CME 06.22.2024

Glioblastoma and diffuse astrocytoma, IDH wildtype

Introduction

Overview

Diffuse astrocytomas, IDH wildtype, encompass a variety of histologies, with glioblastomas being the most common and most aggressive subtype. This review focuses on diagnosis and management of adult glioblastoma, IDH wildtype, and discusses other histologies included in the 2016 World Health Organization classification of IDH wildtype astrocytoma.

Key points

• Glioblastoma, IDH wildtype, is the most common malignant primary brain tumor with an often aggressive clinical course.

• Treatment of glioblastoma, IDH wildtype, is multimodal and includes maximal safe surgical resection, fractionated radiation, chemotherapy, and tumor-treating fields.

• Age and performance status at diagnosis in glioblastoma may influence optimal dosing of radiation and chemotherapy.

• Molecular testing should be considered in diffuse astrocytomas that are IDH1 R132H wildtype by immunohistochemistry with high clinical or radiologic suspicion for glioblastoma to evaluate hallmark features of molecular glioblastoma.

• Diffuse astrocytomas, IDH wildtype, also include diffuse midline gliomas with H3 K27 mutation, pleomorphic xanthoastrocytomas, and other distinct entities and are defined by other molecular signatures and are not discussed in detail in this review.

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