Anaplastic Astrocytoma

Anaplastic Astrocytoma is a malignant brain tumor witha median survival for patients of 3 years from initial diagnosis, despite intervention through surgery, radiation and chemotherapy.

Primary brain tumors are a heterogeneous group of neoplasms with varied treatment strategies and outcomes. Anaplastic Astrocytomas (AA) are considered grade III, and are highly aggressive, malignant tumors that often occur in young adults and typically recur or progress to a grade IV glioblastoma within several years of diagnosis. See below for background information on World Health Organization (WHO) classification of tumors.

Anaplastic Astrocytoma is the most common form of anaplastic glioma (AG).  Approximately 1.16 persons in every 100,000 will be diagnosed with AG in any given year in the US (Source: 2/2011 CBTRUS publication). In the US alone, approximately 3,600 new cases of AG are diagnosed each year with a median survival of just over 3 years despite surgery, radiation and chemotherapy. Prevalence of AG is estimated to be approximately 20,000 people in the US.  Based on this prevalence, AG is considered an orphan disease.

 

WHO grading of central nervous system tumors

  • Grade I includes lesions with low proliferative potential and a frequently discrete non-infiltrative nature; surgical resection is the main treatment.
  • Grade II includes lesions that are infiltrating and low in mitotic activity, but recur. Some tumor types tend to progress to higher grades of malignancy.
  • Grade III includes lesions with histologic evidence of malignancy, generally in the form of mitotic activity, clearly expressed infiltrative capabilities, and anaplasia.
  • Grade IV includes lesions that are mitotically active with vascular proliferation, necrosis-prone, and generally associated with a rapid pre-operative and post-operative evolution of disease.

The few available treatments for anaplastic astrocytoma have limited efficacy.

For patients with radiographically (MRI) suspected anaplastic astrocytoma, surgery is the initial recommended approach for reducing tumor size and pathologic diagnosis.

After surgery, adjuvant radiation therapy is generally considered to be the standard of care for the treatment of patients diagnosed with AA.

After surgery and radiation therapy, patients typically receive some form of chemotherapy (e.g. themozolomide or Temodar®).  Currently, there are limited options for physicians treating AA with chemotherapy.  The available chemotherapies provide some benefit to patients, but effect is modest and toxicity limit long-term use in AA patients. 

Since there is a need for better treatment options for patients diagnosed with AA, we are evaluating eflornithine in a clinical study.  Patients with AA who have progressed or recurred following surgery, RT and chemo may be eligible for participation in our clinical trial.