How do you approach treatment of an IDH wild-type low-grade astrocytoma in an elderly patient?

Inherent in this good question are really two separate issues: 1) how to approach IDH-wt LGG and 2) how to treat glioma in the elderly (and/or frail).

The first issue is addressed by the recent cIMPACT-NOW update #3 which states that in the presence of an IDH-wt gr 2-3 glioma, the presence of one of ...

Lower grade gliomas, especially IDH-mutant, tend to occur more commonly in younger patients. However, occasionally elderly patients are also diagnosed with WHO G2 astrocytoma. For example, in NRG Oncology RTOG 0424, a single arm phase 2 trial of RT plus temozolomide in high-risk low grade glioma, th...