Medical Need and Quality of Life in Patients with Grade 2 IDH-mutant glioma: Insights from Current Management Practices and Caregiver Perspectives in France

Background Grade 2 IDH-mutant gliomas, though slow-growing, remain challenging to manage due to their heterogeneity and lack of curative treatments. This study aimed to assess their current diagnostic and treatment practices and perceived medical needs in France. Methods A survey was conducted among 32 healthcare professionals involved in the management of grade 2 IDH-mutant gliomas in France. Respondents included medical oncologists, neurologists, neurosurgeons, and radiation oncologists. The questionnaire gathered data on diagnostic practices, treatment regimens, and factors influencing treatment decisions. Results The majority of respondents (81.3%) routinely performed multimodal MRI at diagnosis, with 90.6% not conducting a first-line biopsy. The decision to initiate active surveillance alone was primarily guided by post-operative MRI findings (93.8%), histo-molecular subtype (78.1%), and patient age (75.0%). Moreover, 56.3% of patients with astrocytomas and 46.9% of patients with oligodendrogliomas received chemoradiotherapy. For both tumor types, over half of respondents preferred chemotherapy alone (astrocytomas: 56.3%; oligodendrogliomas: 53.1%). Most respondents (81.3%) believe that current treatment options (chemotherapy and radiotherapy) remain suboptimal—mainly due to their side effects. Over 60% reported use of IDH inhibitors (available through waiver access or clinical trials) upon progression for both astrocytomas and oligodendrogliomas. Conclusions This survey highlights the widespread use of multimodal MRI and a preference for avoiding biopsy prior to surgery, with post-operative imaging and molecular features guiding treatment decisions. While current treatment options (chemotherapy and radiotherapy) address some medical needs, respondents emphasized the need of developing options with fewer side effects and effective therapies for patients not requiring immediate treatment.