Single-agent sunitinib, an oral small molecule inhibitor of multiple tyrosine 
kinase receptors, was evaluated for treatment of patients with recurrent 
glioblastoma (GB) and anaplastic astrocytoma (AA). Fourteen AA and 16 GB 
patients, all previously treated with surgery, radiotherapy, and temozolomide, 
were enrolled in a prospective phase II study at either first or second relapse. 
Patients were treated with daily sunitinib for 4 consecutive weeks, followed by 
a 2-week break. For AA patients, the most common side effects were fatigue (86 
%), diarrhea (43 %), hand-foot syndrome (36 %), neutropenia (36 %), 
thrombocytopenia (36 %), and nausea (29 %). In the GB cohort, the most common 
side effects were fatigue (56 %), diarrhea (44 %), neutropenia (31 %), and 
thrombocytopenia (25 %). Six of 14 (43 %) AA and 5 of 16 (31 %) GB patients 
experienced grade 3 or greater toxicities. Five patients discontinued study due 
to drug toxicities. There were no partial or complete responses in either 
cohort; 8/14 (57 %) AA and 5/16 (31 %) GB patients had stable disease at the 
first planned assessment. Progression-free survival at 6 months was 21.5 % (AA) 
and 16.7 % (GB). Median overall survival was 12.1 months (AA) and 12.6 months 
(GB). These results are comparable to those reported in the literature in 
patients treated with standard cytotoxic therapies. This is the largest reported 
trial of sunitinib in recurrent malignant astrocytic gliomas to date, as well as 
contains the largest AA cohort. Nonetheless, sunitinib did not demonstrate 
significant anti-glioma activity in patients with recurrent malignant astrocytic 
gliomas.