How do you approach a recurrence of grade 3 anaplastic astrocytoma after initial treatment with gross total resection followed by RT/adjuvant temozolomide?

Guidelines do not provide strong guidance on who will benefit from temozolomide vs PCV or when to consider re-challenging with temozolomide.

Answer from: Medical Oncologist at Academic Institution

As the questioner notes, this is an area where guidelines and published evidence are not as satisfying as we would like, so treatment has to be individualized. In addition, most trials until very recently did not test IDH status or 1p/19q status so the diagnoses may not be the same as people d...

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Radiation Oncologist at Ohio State University James Cancer Center
Agree with all of above, and would just add that r...

Medical Oncologist at Cancer Care Specialists/Renown Oncology/UNR
If it is gr4, would you do CCNU + Avastin outside ...

Medical Oncologist at University of Utah Huntsman Cancer Institute
I agree that be useful particularly for trial elig...

Answer from: Medical Oncologist at Academic Institution

It depends on the timing of the recurrence. Clinical trial would be the first option. If the recurrence is >1 year after temozolomide, I usually re-challenge with temozolomide. If it's >1 year after RT, then repeat RT/temozolomide is possible too, depending on the tumor location and size. If t...

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Radiation Oncologist at Cancer Care Centers of Brevard
One could also consider optune/tumor treating fiel...

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How do you approach a recurrence of grade 3 anaplastic astrocytoma after initial treatment with gross total resection followed by RT/adjuvant temozolomide?

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