Brain tumor medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Brain tumor Microchapters
Patient Information
Overview
Classification Adult brain tumors Glioblastoma multiforme Oligodendroglioma Meningioma Hemangioblastoma Pituitary adenoma Schwannoma Primary CNS lymphoma Childhood brain tumors Pilocytic astrocytoma Medulloblastoma Ependymoma Craniopharyngioma Pinealoma Metastasis Lung cancer Breast cancer Melanoma Gastrointestinal tract cancer Renal cell carcinoma Osteoblastoma Head and neck cancer Neuroblastoma Lymphoma Prostate cancer
Causes
Differentiating Brain Tumor from other Diseases

Overview

Although there is no generally accepted therapeutic management for primary brain tumors, a surgical attempt at tumor removal or at least cytoreduction (that is, removal of as much tumor as possible, in order to reduce the number of tumor cells available for proliferation) is considered in most cases. However, due to the infiltrative nature of these lesions, tumor recurrence, even following an apparently complete surgical removal, is not uncommon. Postoperative radiotherapy and chemotherapy are integral parts of the therapeutic standard for malignant tumors. Radiotherapy may also be administered in cases of "low-grade" gliomas, when a significant tumor burden reduction could not be achieved surgically.

Chemotherapy may be used with surgery or radiation treatment.

Medical Therapy

Some drugs that are used to treat brain cancer are:

• Everolimus- FDA approved - approved to treat Subependymal giant cell astrocytoma in patients who have Tuberous Sclerosis and are not able to have surgery.
• Bevacizumab- FDA approved - approved to treat Glioblastoma in patients whose disease has not gotten better with other types of treatment.

• Lomustine- FDA approved - used in patients who have already had surgery or radiation therapy

• Temozolomide- FDA approved - used in adults for the treatment of Anaplatic astrocytomas and Glioblastoma multiforme

Other medications used to treat primary brain tumors in children may include:

• Corticosteroids, such as dexamethasone, to reduce brain swelling
• Medicines such as urea or mannitol to reduce brain swelling and pressure
• Anticonvulsants, such as evetiracetam (Keppra), to reduce seizures
• Pain medications
• Antacids or histamine blockers to control

Contraindicated medications

Cerebral neoplasm is considered an absolute contraindication to the use of the following medications:

• Streptokinase