{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:49:31Z","timestamp":1791413371848,"version":"4.3.3"},"reference-count":55,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"29","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"published-print":{"date-parts":[[2026,10,10]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Age \u226540 years is regarded as a high-risk feature and an indication for adjuvant chemoradiotherapy for patients with lower-grade glioma in clinical practice guidelines. It is unclear whether age remains a relevant prognostic factor for contemporary definitions of lower-grade gliomas in the molecular era.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      The Prospective Gliomas Research (PROGRES) database contains individual patient-level data from 11 prospective clinical trials or observational registries of histologically defined lower-grade 2-3 oligodendroglioma or astrocytoma. We determined the association of age (18-39 years\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      \u226540 years) with progression-free survival (PFS) stratified by isocitrate dehydrogenase 1 or 2 (\n                      <jats:italic toggle=\"yes\">IDH1\/2<\/jats:italic>\n                      ) status, using log-rank tests and Cox regression models. We validated our findings in a separate multi-institutional retrospective cohort (Retrospective Glioma Research [REGRES] database).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      We identified 1,619 and 1,292 eligible patients in the PROGRES and REGRES cohorts, respectively.\n                      <jats:italic toggle=\"yes\">IDH<\/jats:italic>\n                      -wildtype tumors were more common in patients 40 years and older (38%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      5%, odds ratio: 11.3 [95% CI, 6.5 to 19.7]). Age was associated with PFS in\n                      <jats:italic toggle=\"yes\">IDH<\/jats:italic>\n                      -wildtype (5-year PFS for \u226540\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      18-39 years: 6%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      24%, hazard ratio [HR], 1.74 [95% CI, 1.21 to 2.50]) but not in\n                      <jats:italic toggle=\"yes\">IDH<\/jats:italic>\n                      -mutant glioma (60%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      59%, HR, 0.89 [95% CI, 0.76 to 1.05],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      &lt; .001). In\n                      <jats:italic toggle=\"yes\">IDH<\/jats:italic>\n                      -wildtype tumors, older age predicted aggressive molecular features, including\n                      <jats:italic toggle=\"yes\">TERT<\/jats:italic>\n                      promoter mutation (65%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      28%),\n                      <jats:italic toggle=\"yes\">EGFR<\/jats:italic>\n                      amplification (41%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      15%), and chromosome +7\/\u201310 alteration (57%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      25%). In a pooled analysis of four clinical trials, age was not predictive of a benefit from chemoradiotherapy versus radiotherapy alone for\n                      <jats:italic toggle=\"yes\">IDH<\/jats:italic>\n                      -mutant glioma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>In the absence of additional clinical or molecular risk factors, age alone should not be considered an indication for administration or deferral of adjuvant treatment. Practice guidelines should be revised to reflect contemporary prognostic factors in the molecular era.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco-25-01846","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T20:00:21Z","timestamp":1786564821000},"page":"2811-2823","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic and Predictive Effect of Age in Molecularly Defined Lower-Grade Gliomas"],"prefix":"10.1200","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8888-6077","authenticated-orcid":true,"given":"Connor J.","family":"Kinslow","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY"},{"name":"Department of Radiation Oncology, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian, New York, NY"},{"name":"Herbert Irving Comprehensive Cancer Center, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Minniti","sequence":"additional","affiliation":[{"name":"IRCCS Neuromed, Pozzilli, Isernia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0022-4533","authenticated-orcid":true,"given":"Paul D.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9833-2374","authenticated-orcid":true,"given":"Michael A.","family":"Vogelbaum","sequence":"additional","affiliation":[{"name":"Department of Neuro-Oncology, H. 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