Scotland’s medicines regulator has approved the first targeted therapy for low grade brain tumours in a generation. brainstrust calls on England to address the inequity of access to Vorasidenib.
Scotland’s medicines regulator has approved the first targeted therapy for low grade brain tumours in a generation. brainstrust calls on England to address the inequity of access to Vorasidenib. The Scottish Medicines Consortium (SMC) today confirmed that Vorasidenib (Voranigo) will be available on the NHS in Scotland for adults and young people aged 12 and over with IDH-mutant grade 2 astrocytoma or oligodendroglioma following surgery, where immediate chemotherapy and radiotherapy is not required.

The decision makes Scotland the first nation in the UK to offer this medicine routinely on its health service. For people living with a low-grade (grade 2) brain tumour, today’s news is the moment many have been waiting for. After surgery, people have faced a stark choice: active surveillance to monitor when the tumour changes or accept the burden of radiotherapy and chemotherapy and all the neurologic and neurocognitive consequences that these treatments bring. Vorasidenib changes this. Clinical trial data from the INDIGO study 1 showed it nearly tripled the time people went without disease progression – a medium of 27.7 months compared to 11.1 months on placebo – while helping to shrink tumour volume and delay the need for further treatment. In addition, the results of a follow up study 2 published Oct 25 report the positive effect of Vorasidenib on tumour growth rate, health-related quality of life (HRQOL), neurocognitive function and seizure control. Dr Helen Bulbeck, director of policy and services at brainstrust, said:

“This is a genuinely historic day for people in Scotland who are living with a low-grade brain tumour. For the first time, there is a targeted treatment that can actively slow tumour growth without the long-term harms of radiotherapy or chemotherapy. brainstrust has advocated for access to Vorasidenib since the INDIGO trial data emerged, and we are proud to have been part of the process that got us here. “But our celebration is tempered by real concern for patients in England. The NICE appraisal has been paused, and access is unlikely before the summer at the earliest. That is months more of living with a growing tumour, months more of uncertainty. We urge NICE and NHS England to move without delay.”
England: a widening postcode lottery
Vorasidenib received marketing authorisation from the UK medicines regulator, the MHRA, in September 2025. Scotland’s SMC, working under its PACE process for rare conditions, has now completed its evaluation and accepted the medicine. In England NICE’s draft guidance– published in October 2025 – recommended against routine use on cost effectiveness grounds. The appraisal was subsequently paused in January 2026, at the manufacturer’s request, to await the introduction of the revised NICE thresholds in April 2026. New draft
guidance is expected on 29 April 2026. Even under an optimistic scenario, NHS England would not be required to make the treatment available until July 2026 at the earliest. For the estimated several hundred patients in England who are eligible right now, this means a period of unequal access within the same country. For those patients, today news brings hope but not yet relief. brainstrust believes they deserve better, and sooner.
The patient voice that helped this happen
This decision was not reached by evidence alone. Central to the SMC’s process is a Patient and Clinician Engagement (PACE) meeting, at which people living with brain tumours and their families have the opportunity to share with the committee directly what life with this diagnosis feels like – the fear of a tumour that will progress, the toll of waiting, the impact on work, relationships and identity, the loss of life’s purpose and what access to a new
treatment would mean. brainstrust was proud to collaborate with the IBTA in its submission and we acknowledge
and thank everyone who contributed to this process – those who submitted evidence, participated in engagement meetings, responded to surveys, and who had the courage to put their experiences on record to help strangers understand with it means to live with a low grade brain tumour. Their voices were not a footnote; they mattered to the outcome. 
Will Jones, CEO, brainstrust comments ““Decisions like this do not happen in a vacuum. They happen because people who are living with these tumours – and the people who love and care for them – are willing to speak up about the impact it has on their lives. The SMC process takes that seriously and as do we at brainstrust. Patient involvement is not a box ticking exercise; it is how good decisions are made. It shapes the decisions that shape people’s lives.’
About IDH mutant low-grade glioma
Grade 2 astrocytomas and oligodendrogliomas are slow growing but incurable brain tumours that disproportionately affect people in their twenties, thirties and forties – people building careers, raising families, making plans. The presence of IDH1 or IDH2 mutations, found in the majority of these tumours – defines both the disease biology and treatment response. Until Vorasidenib, no targeted therapy had been approved for this population anywhere in the world. After surgery, the standard of care was active surveillance: regular scans, and waiting for the tumour to transform, caught between a rock and a hard place of whether to proceed with chemotherapy and radiotherapy, which come at a cost to quality of life. So always living in the shadow of a treatment they hoped to delay but could not avoid.
1 1Mellinghoff IK, van den Bent MJ, Blumenthal DT, Touat M, Peters KB, Clarke J, Mendez J, Yust- Katz S, Welsh L, Mason WP, Ducray F, Umemura Y, Nabors B, Holdhoff M, Hottinger AF, Arakawa Y, Sepulveda JM, Wick W, Soffietti R, Perry JR, Giglio P, de la Fuente M, Maher EA, Schoenfeld S, Zhao D, Pandya SS, Steelman L, Hassan I, Wen PY, Cloughesy TF; INDIGO Trial Investigators. Vorasidenib in IDH1- or IDH2-Mutant Low-Grade Glioma. N Engl J Med. 2023 Aug 17;389(7):589- 601. doi: 10.1056/NEJMoa2304194. Epub 2023 Jun 4. PMID: 37272516; PMCID: PMC11445763. 2 Cloughesy TF, van den Bent MJ, Touat M, Blumenthal DT, Peters KB, Ellingson BM, Clarke JL, Mendez J, Yust-Katz S, Welsh L, Mason WP, Ducray F, Umemura Y, Nabors B, Holdhoff M, Hottinger
AF, Arakawa Y, Sepulveda JM, Wick W, Soffietti R, Perry J, Giglio P, de la Fuente M, Maher E, Bottomley A, Tron AE, Yi D, Zhao D, Pandya SS, Steelman L, Hassan I, Wen PY, Mellinghoff IK; INDIGO trial investigators. Vorasidenib in IDH1-mutant or IDH2mutant low-grade glioma (INDIGO): secondary and exploratory endpoints from a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2025 Oct 29:S1470-2045(25)00472-3. doi: 10.1016/S1470-2045(25)00472-3. Epub ahead of print. PMID: 41175888.

