Treatments for astrocytoma (IDH-mutant)

The treatments for astrocytoma (IDH-mutant) depend on the grade of the tumour. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Surgery is usually the first treatment for astrocytomas. It is used to remove as much of the tumour as possible.

Surgery is followed by radiation therapy or chemotherapy or both.

Find out more about surgery for brain and spinal cord tumours.

Radiation therapy uses high-energy rays or particles to destroy cancer cells. Radiation therapy is used after surgery to treat the area where the astrocytoma was removed and any cancer cells that may be left. Radiation therapy may also be used by itself as the main treatment if the tumour can’t be removed, or if you aren’t healthy enough or don’t want to have surgery.

Find out more about radiation therapy for brain and spinal cord tumours.

Chemotherapy uses drugs to destroy cancer cells. Chemotherapy is often used with radiation therapy after surgery to treat astrocytomas.

The most common chemotherapy drug used to treat astrocytoma is temozolomide. It is offered after surgery or if the tumour can’t be removed with surgery.

The most common chemotherapy drug combination used for astrocytoma is PCV (procarbazine, lomustine and vincristine).

Find out more about chemotherapy for brain and spinal cord tumours.

Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells and limit harm to normal cells.

Vorasidenib (Voranigo) targets mutations in the isocitrate dehydrogenase (IDH) genes, IDH1 and IDH2. It is used for astrocytoma grade 2 tumours that have the IDH mutations. It is not offered for grade 3 astrocytomas.

Larotrectinib (Vitrakvi) targets the neurotrophic tyrosine receptor kinase (NTRK) gene fusion. It may be used for astrocytoma tumours that have this gene fusion and cannot be removed with surgery or for tumours that have no other treatment options.

Find out more about targeted therapy for brain and spinal cord tumours.

Corticosteroids and antiseizure medicines (anticonvulsants) may be offered to help lessen the symptoms caused by astrocytomas and treatment side effects.

Find out more about corticosteriods and antiseizure medicines.

Recurrent astrocytoma means that the cancer has come back after it has been treated. Treatment options may include:

• surgery if the tumour can be safely removed
• chemotherapy
• radiation therapy to areas that have not yet had radiation treatment
• targeted therapy with bevacizumab (Avastin and biosimilars)

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Talk to your doctor about clinical trials open to people with brain and spinal cord tumours in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.