Isocitrate Dehydrogenase (IDH) Mutations in Gliomas: Effect on Tumor Progression, Metabolism, Treatments, and Patient Outcomes

Gliomas are a diverse group of tumors that arise from glial or progenitor cells in the brain or spinal cord, which make up the central nervous system (CNS), and their classification and prognosis increasingly depends on genetic modifications, especially mutations in IDH1 and IDH2. These mutations are most common in low grade gliomas and secondary glioblastomas, where they produce the oncometabolite D-2-hydroxyglutarate, disrupting cell metabolism and epigenetic regulation. This review analyzes how IDH1/2 mutations can affect tumor energy use, patient outcomes, and treatment response by surveying existing research in the field. Findings show that IDH-mutant gliomas have altered metabolic activity, significantly better survival than wild-type tumors, greater sensitivity to surgery, radiation, chemotherapy, and newer targeted therapies such as IDH inhibitors and immunotherapy. Overall, IDH mutations act as key drivers linking tumor metabolism, prognosis, and treatment response, although more research connecting molecular and clinical findings is still needed to improve treatments and therapies.