In what circumstances would you consider use of IDH inhibitors in high-grade astrocytomas?

Please forgive me for the length and directness of my response, but I believe it is important to first go over the INDIGO trial and explain why, in my opinion, it was a highly questionable study, with multiple significant methodological flaws and dubious evidence of Vorasidenib's efficacy.

INDIGO tri...

INDIGO has stirred up the blues, as can clearly be seen by the responses here. The issues raised are extremely valid and rather than rehash the critical points already brought out by both Drs. @Dr. First Last and @Dr. First Last, let me direct the readers to a very detailed summary paper that contex...

For patients with grade 3 IDH-mutant glioma, adjuvant therapy (after maximal safe resection) with RT followed by TMZ or PCV is generally considered the standard-of-care for all patients. Institutional practice varies regarding the choice of TMZ or PCV due to an often greater toxicity profile with PC...