Isocitrate dehydrogenase mutation and microenvironment in gliomas: Do immunotherapy approaches matter?

Purpose of review  - Gliomas with mutations in the gene for isocitrate dehydrogenase (IDH) display a unique immune microenvironment that is distinct from IDH-wildtype gliomas. This unique immune microenvironment is shaped by 2-hydroxyglutarate (2-HG), an oncometabolite produced by mutant I...

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1. Verfasser: Platten, Michael (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: December 2025
In: Current opinion in neurology
Year: 2025, Jahrgang: 38, Heft: 6, Pages: 706-710
ISSN:1473-6551
DOI:10.1097/WCO.0000000000001426
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/WCO.0000000000001426
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/co-neurology/abstract/2025/12000/isocitrate_dehydrogenase_mutation_and.13.aspx
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Verfasserangaben:Michael Platten

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520 |a Purpose of review  - Gliomas with mutations in the gene for isocitrate dehydrogenase (IDH) display a unique immune microenvironment that is distinct from IDH-wildtype gliomas. This unique immune microenvironment is shaped by 2-hydroxyglutarate (2-HG), an oncometabolite produced by mutant IDH. These features provide an opportunity to develop and test targeted immunotherapies for IDH-mutant gliomas. - Recent findings  - IDH-mutant gliomas are characterized by an immunosuppressive tumor immune microenvironment (TIME) that suppresses the infiltration and activation of tumor-specific T cells. This is owed both to direct effects of the oncometabolite 2-hydroxyglutarate on glioma-infiltrating T cells and myeloid cells and indirect effects on the chemotactic profile of tumor cells. These immunosuppressive effects are reversed by IDH inhibitors recently approved for the treatments of IDH-mutant gliomas. At the same time, clinical trials have demonstrated encouraging results for targeted immunotherapies using vaccines targeting the most frequent mutation IDH1R132H. - Summary  - The reversal of the immunosuppressive effects by IDH inhibitors has opened exciting avenues for combinatorial immunotherapies such as vaccines and immune checkpoint inhibitors. 
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