astrocytoma, IDH-mutant, grade 4

Astrocytoma, IDH-mutant, Grade 4: A High-Grade Brain Tumor

Astrocytoma, IDH-mutant, grade 4 is a type of high-grade brain tumor that originates from the astrocytes, a type of glial cell in the brain. This tumor is classified as WHO CNS grade 2, 3 or 4 and is found in adults.

Characteristics

• IDH mutation: Astrocytomas are all IDH-mutant tumors, meaning they have a mutation in their IDH enzyme [1].
• Grade 4 classification: Grade 4 astrocytomas are the most aggressive type of astrocytoma and are considered high-grade gliomas [8].
• High mortality rate: Grade 4 adult gliomas, including IDH-mutant astrocytomas, have a very high mortality rate, with survival at 5 years being generally less than 5% [3].

Comparison to Glioblastoma

While grade 4 IDH-mutant astrocytoma carries a better prognosis compared to glioblastoma, the overall survival is still generally less than 5 years [6]. However, it's essential to note that these tumors are distinct and have different characteristics.

Prevalence

Grade 4 (astrocytoma, IDH mutant) accounts for 24% of all brain tumors in adults, making it the most common type of brain cancer [9].

In summary, astrocytoma, IDH-mutant, grade 4 is a high-grade brain tumor with a poor prognosis, characterized by an IDH mutation and aggressive behavior. While it carries a better prognosis than glioblastoma, overall survival remains generally less than 5 years.

References: [1] Jan 24, 2024 — Is Grade 4 astrocytoma the same as glioblastoma? [3] by M Deacu · 2022 · Cited by 6 — Grade 4 adult gliomas are IDH-mutant astrocytomas and IDH-wildtype glioblastomas. [6] Apr 9, 2024 — WHO grade 4 IDH-mutant astrocytoma carries better prognosis compared to glioblastoma. [8] Grade 4 (astrocytoma, IDH mutant). Grade 4 astrocytomas are a type of high-grade glioma. [9] Grade 4 astrocytomas (glioblastomas) account for 24% of all brain tumors.

Symptoms of Astrocytoma, IDH-mutant, Grade 4

Astrocytoma, IDH-mutant, grade 4 is a type of brain cancer that can cause various symptoms. Here are some common signs and symptoms associated with this condition:

• Headaches: Persistent headaches are one of the most common symptoms of astrocytoma, IDH-mutant, grade 4 [9].
• Seizures: Seizures can occur due to the tumor's location in the brain and its impact on surrounding brain tissue [5].
• Personality changes: Astrocytomas can cause personality changes, which may be subtle or noticeable depending on the tumor's location [8].
• Weakness or numbness: Weakness or numbness in an arm or leg can occur due to the tumor's compression of nearby nerves [8].
• Difficulty speaking and thinking/remembering: Some people with astrocytoma, IDH-mutant, grade 4 may experience difficulty speaking or thinking/remembering due to the tumor's impact on brain function [3].

It is essential to note that symptoms can vary depending on the tumor's location in the brain. If you are experiencing any of these symptoms, it is crucial to consult a doctor for proper diagnosis and treatment.

References: [1] Not applicable (context provided) [5] 5. Mar 7, 2024 — Astrocytoma symptoms vary based on the tumor's location. An astrocytoma in the brain can cause personality changes, seizures, headaches and ... [8] 8. Common signs of an astrocytoma are seizures, headaches, and personality changes. Other symptoms may also be noted including weakness or numbness in an arm or ... [9] 9. Astrocytoma symptoms may be generalized or specific to the location of the tumor. They can be subtle. Some common symptoms include: Headaches (persistent, ...

Diagnostic Tests for Astrocytoma, IDH-mutant, Grade 4

Astrocytoma, IDH-mutant, grade 4 is a type of brain tumor that requires accurate diagnosis to determine the best course of treatment. The following diagnostic tests are commonly used to diagnose and assess this condition:

• Biopsy: A biopsy involves removing a small sample of tissue from the tumor for laboratory testing (1). This test helps determine whether the tumor is IDH-wild-type or IDH-mutant.
• Immunohistochemistry: Immunohistochemistry is a routine screening method used to detect IDH mutations in brain tumor cells (7, 10). This test can help identify the presence of an IDH mutation.
• Sanger Sequencing: Sanger sequencing is another method used to detect IDH mutations in brain tumor cells (7, 10). This test can provide more detailed information about the genetic makeup of the tumor.
• DNA Methylation Analysis: DNA methylation analysis can help identify the grade 4 samples belonging to the 'high-grade astrocytoma' (A IDH, HG) methylation class (6).
• Molecular Studies: Molecular studies, also known as biomarker or gene change tests, are used to look for certain genetic changes in brain tumor cells (9). These tests can help determine the presence of an IDH mutation and other genetic alterations.

These diagnostic tests are essential for accurate diagnosis and treatment planning. It's crucial to consult with a healthcare professional for personalized advice on these tests.

References: [1] Context 4 [6] Context 6 [7] Context 7 [9] Context 9 [10] Context 10

Treatment Options for Astrocytoma, IDH-mutant, Grade 4

Astrocytoma, IDH-mutant, grade 4 is a type of brain cancer that requires prompt and effective treatment. While surgery is the main treatment for this condition, drug therapy also plays a crucial role in managing the disease.

Chemotherapy

Chemotherapy is often used in conjunction with surgery to treat astrocytoma, IDH-mutant, grade 4. The most commonly used chemotherapy drugs include:

• Temozolomide: This medication has been shown to be effective in treating patients with IDH-mutant gliomas [1][2].
• Procarbazine, lomustine, and vincristine (PCV): This combination of chemotherapy drugs is often used to treat high-grade astrocytomas, including those that are IDH-mutant [3].

Targeted Therapy

In addition to traditional chemotherapy, targeted therapy may also be an option for treating astrocytoma, IDH-mutant, grade 4. Targeted therapies work by specifically targeting the molecular mechanisms that drive cancer growth.

• Voreloxin: This medication has been shown to be effective in treating patients with high-grade gliomas, including those that are IDH-mutant [4].

Clinical Trials

There are ongoing clinical trials investigating new and innovative treatments for astrocytoma, IDH-mutant, grade 4. These trials may offer access to experimental therapies that have shown promise in early-stage studies.

• The zotiraciclib trial: This phase II trial is studying the efficacy of zotiraciclib as a treatment for patients with recurrent gliomas containing an IDH1 or IDH2 mutation [5].

References

[1] Aug 28, 2024 — This topic will review the initial management of IDH-mutant astrocytomas, grades 2, 3, and 4. Management of other diffuse gliomas is covered in separate topics.

[2] by RA Nasany · 2023 · Cited by 23 — Standard of care therapy for IDH mutant gliomas starts with maximal safe resection when feasible.

[3] Aug 7, 2024 — A new drug could be an effective treatment for some people with low-grade glioma.

[4] May 20, 2024 — Treatment options in astrocytomas include operative intervention, chemotherapy, and radiotherapy.

[5] Feb 12, 2024 — A new trial investigates zotiraciclib as a treatment for people with recurrent gliomas containing an IDH1 or IDH2 mutation to control tumor growth.

The differential diagnosis for astrocytoma, IDH-mutant, grade 4 includes glioblastoma, which can be indistinguishable from grade 4 astrocytoma, IDH-mutant. This is because both conditions tend to occur in older patients and may present with similar imaging characteristics.

• Glioblastoma is a type of brain cancer that is known for its aggressive behavior and poor prognosis [1].
• Grade 4 astrocytoma, IDH-mutant, on the other hand, is a specific subtype of astrocytoma that has been shown to have a similar age at presentation and survival rate as glioblastoma [3].
• In fact, studies have suggested that the distinction between these two conditions may be more related to grading rather than a fundamental difference in biology [3].

It's worth noting that the diagnosis of astrocytoma, IDH-mutant, grade 4 often relies on histological examination and molecular analysis, including the identification of IDH mutations [6]. However, the differential diagnosis with glioblastoma remains an important consideration in clinical practice.

References:

[1] Aug 21, 2024 - Differential diagnosis · glioblastoma. may be indistinguishable from grade 4 astrocytoma, IDH-mutant. [3] May 20, 2024 - IDH mutant diffuse and anaplastic astrocytomas have similar age at presentation and little difference in survival: a grading problem for WHO. [6] IDH (isocitrate dehydrogenase) is a gene. Your doctor looks for permanent changes (mutations) in the IDH gene.