Glioblastoma and anaplastic astrocytoma are two of the most aggressive and 
common glioma malignancies in adults. These high-grade gliomas (HGG) universally 
recur despite aggressive treatment modalities and have a median overall survival 
(mOS) of approximately 14 months from initial diagnosis. Upon recurrence, there 
is no standard of care and these patients have a dismal prognosis of around 
9 months at time of recurrence. Areas covered: In this article, we assess the 
newly published phase I data of Toca 511 and Toca FC, a two-drug combination 
therapy for recurrent HGG (rHGG) tumors, for effectiveness and safety. Expert 
opinion: These early studies provide very encouraging results for Toca 511 and 
Toca FC in rHGG. This therapy had a response rate of 11.3% and a mOS of 
11.9 months in 56 patients, an improvement compared to historical controls. 
Furthermore, all responders were complete responses after extended follow-up. 
The drug is well tolerated for most patients. Responders tended to be young and 
have high-performance scores prior to beginning therapy, but more studies are 
necessary to understand the patient profile that receives the most benefit. 
Randomized-controlled trials are warranted for Toca 511 and Toca FC to confirm 
drug efficacy.