Medical Therapy for Brain Tumors

Some brain and spine tumors, especially those found to be malignant, will be treated with medical therapy. “Medical therapy” is a term for medications that are administered to a patient to stop or slow the growth of cancer cells.

Brain tumors can be difficult to treat with medications because the brain is protected by what’s referred to as the “blood-brain barrier,” a mechanism by which blood vessels leading into the brain are able to filter out foreign substances. Only a few drugs are able to cross the blood-brain barrier successfully.

Patients undergoing medical therapy for brain or spine tumors may receive one or more different forms of treatment, including chemotherapy, targeted therapy, and immunotherapy.

When do patients receive medical therapy?

Patients typically receive medical therapy after undergoing surgery to remove their tumor. This is called “adjuvant” medical therapy.

Patients may also receive medical therapy alone to treat their brain tumors if it is known that the medicine can pass through the blood-brain barrier and access cancer cells in the brain.

Occasionally, if a tumor is too large to be removed safely, patients may be given medical therapy before the surgery in order to shrink the tumor to a more manageable size. This is called “neoadjuvant” medical therapy.

Chemotherapy for brain tumors

Chemotherapies are medications designed to kill cancer cells.

There are several chemotherapy drugs available for brain and spine tumors. Patients may take one drug at a time or a combination of drugs.

Physicians and surgeons have developed several methods for administering chemotherapy that overcomes the blood-brain barrier.  One method is to infuse the drug into the cerebrospinal fluid that surrounds the brain. Another method is to place a tiny wafer of chemotherapy directly into the tumor itself. The wafer will dissolve slowly over time and release a steady dose of medication into the tumor.

Other chemotherapies, including the common glioblastoma drug Temodar (temozolomide), are taken as pills.

Immunotherapy for brain tumors

Immunotherapies are medications and other treatments that fight cancer using the patient’s own immune system.

Brain and spine tumor patients typically access immunotherapies in clinical trials. At Siteman, we offer a number of clinical trials exploring immunotherapies, including a Phase I study testing a new immunotherapy drug.

Vaccines

Immunotherapies are often given as drugs, but in clinical trials, physicians and scientists are also using personalized vaccines to target patients’ brain tumor cells.

It’s important to mention that these vaccines are only administered to patients who have already been diagnosed with, and have undergone treatment for, a brain tumor. At this time, there is no vaccine that can prevent brain tumors from developing in the first place.

There are several approaches to creating vaccines for brain tumor patients, but the most common one involves taking a sample of the patient’s tumor tissue and analyzing it in the laboratory, looking for genetic mutations and unique molecular features. Then, medical scientists design a vaccine that stimulates the patient’s immune system to attack those unique features in the patient’s tumor.

In clinical trials, including a trial carried out right here at Siteman, vaccines have shown promise in prolonging the lifespan of patients with glioblastoma multiforme.

Targeted therapy for brain tumors

As their name suggests, targeted therapies are designed to focus in on certain key mechanisms and processes in cancer cells, rather than attacking the cell as a whole. This means that targeted therapies can destroy or disable cancer cells while disturbing fewer healthy cells than traditional chemotherapies.

Targeted therapies are typically administered if a patient’s tumor is not responding well to chemotherapies.

Clinical trials for brain tumors

Washington University physicians and scientists at Siteman are striving to improve medical therapies for brain tumors. They routinely design and run clinical trials examining new drugs, new drug combinations, and other novel approaches.

Some of our clinical trials are: