High-grade astrocytoma

High-grade astrocytoma is a group of aggressive malignant brain tumors arising from astrocytes, the star-shaped glial cells that support neurons in the central nervous system. This category encompasses World Health Organization (WHO) grade III astrocytomas (anaplastic astrocytoma) and grade IV astrocytomas (glioblastoma multiforme, or GBM). These tumors primarily affect the brain but can occasionally occur in the spinal cord. High-grade astrocytomas are characterized by rapid growth, infiltration into surrounding brain tissue, and a tendency to recur after treatment. Key symptoms depend on tumor location and size but commonly include progressive headaches (often worse in the morning), seizures, focal neurological deficits such as weakness or numbness on one side of the body, speech difficulties, cognitive and personality changes, visual disturbances, and signs of increased intracranial pressure including nausea and vomiting. Symptoms may develop rapidly over weeks to months due to the aggressive nature of these tumors. The current treatment landscape involves a multimodal approach. Standard first-line therapy typically includes maximal safe surgical resection followed by concurrent radiation therapy and temozolomide chemotherapy (the Stupp protocol), particularly for glioblastoma. For anaplastic astrocytomas, treatment may also include radiation with or without chemotherapy. Molecular markers such as IDH mutation status, MGMT promoter methylation, and 1p/19q codeletion status are increasingly used to guide treatment decisions and predict prognosis. Tumor treating fields (TTFields) have been approved as an additional treatment modality for glioblastoma. Despite aggressive treatment, prognosis remains poor, especially for glioblastoma, with median survival of approximately 14-16 months. Clinical trials investigating immunotherapy, targeted therapies, and novel drug delivery methods are ongoing and represent areas of active research.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

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