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The STELLAR trial was a large, randomized multi-center study testing eflornithine plus lomustine versus lomustine alone in patients with recurrent anaplastic astrocytoma.At the time the study began in 2016, tumors from all enrolled patients were classified as grade 3 astrocytoma, but the 2021 updates to tumor classifications later showed that the patients had different tumor types, including grade 3 IDH-mutant astrocytoma, grade 4 tumors, and glioblastoma. When researchers analyzed results from the the entire cohort , the combination treatment did not improve overall survival compared with lomustine alone. However, when they did a subset analysis specifically on patients with recurrent grade 3 astrocytoma that carried an IDH mutation, the results were significant. In this group, people who received the combination had a median survival of nearly 35 months, compared to 24 months with just lomustine alone. Progression-free survival with the combination was almost 16 months, versus just over 7 months with lomustine alone. These findings have the potential to guide future clinical practice for treatment of recurrent grade 3 IDH-mutant astrocytoma.