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IDH2 mutations at codons 140 and 172 do the same job as IDH1 R132, producing 2-HG. Enasidenib is approved for relapsed AML with them, and vorasidenib for grade 2 gliomas with either IDH gene mutated.
R140Q is the commonest IDH2 mutation in AML; R172K predominates in glioma and angioimmunoblastic T-cell lymphoma. Enasidenib (Idhifa, 2017) is labelled for relapsed or refractory AML with an IDH2 mutation as detected by an FDA-approved test, the Abbott RealTime IDH2 assay listing R140Q, R140L, R140G, R140W, R172K, R172M, R172G, R172S and R172W; vorasidenib covers IDH2 R172 mutations in grade 2 glioma with the Oncomine Dx Target Test. IDH2-mutant AML has a lower rate of differentiation syndrome recognition problems only because the drug is older; the risk is the same class effect.
In plain words · A metabolic enzyme whose mutant form produces a molecule that scrambles how genes are read; blocking it slows brain tumours and leukaemias.
An IDH2 mutation in acute myeloid leukaemia that has come back opens enasidenib tablets; in a grade 2 glioma after surgery it opens vorasidenib. Both drugs can cause differentiation syndrome in leukaemia, a reaction your team will watch for in the first weeks.
Written only from the label or guideline text cited on this page. Not medical advice; your own report and the reading your team gives it come first.
An IDH2 codon 140 or 172 substitution (R140Q, R140L, R140G, R140W, R172K, R172M, R172G, R172S, R172W) by PCR or sequencing.
“R140Q, R140L, R140G, R140W, R172K, R172M, R172G, R172S, and R172W”
FDA: List of FDA-Authorized Companion Diagnostic Devices| Threshold | Drug | Cancer | Regulator | Source |
|---|---|---|---|---|
| IDH2 mutation | Enasidenib | IDH1- and IDH2-mutated acute myeloid leukaemia | FDA | label |
| Susceptible IDH1 or IDH2 mutation, grade 2 glioma | Vorasidenib | Oligodendroglioma, IDH-mutant and 1p/19q-codeleted | FDA | label |
| Device | Maker | Indication and sample | Drug | PMA / 510(k) |
|---|---|---|---|---|
| Abbott RealTime IDH2 | Abbott Molecular | Acute Myeloid Leukemia - Peripheral Blood or Bone Marrow | Enasidenib | P170005 (08/01/2017) |
Matched on the name and aliases of the readout in the title, setting and summary of each trial; a match is a mention, not proof the readout was an entry criterion.
Shares 1p/19q codeletion, IDH1 R132 mutation, Astrocytoma, IDH-mutant (grades 2 to 4) and the tag biomarker.
Shares 1p/19q codeletion, Vorasidenib, Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, Astrocytoma, IDH-mutant (grades 2 to 4).
Shares IDH1 R132 mutation, Acute myeloid leukaemia and the tag biomarker.
Shares Vorasidenib, IDH1 / IDH2 and the tag idh.
Shares IDH1 R132 mutation, IDH1- and IDH2-mutated acute myeloid leukaemia, Astrocytoma, IDH-mutant (grades 2 to 4), IDH1 / IDH2.
Shares IDH1 R132 mutation, Acute myeloid leukaemia and the tag biomarker.
Shares Enasidenib, IDH1- and IDH2-mutated acute myeloid leukaemia.
Shares Vorasidenib, Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, Astrocytoma, IDH-mutant (grades 2 to 4), IDH1 / IDH2.