Brain Tumors: Primary - Radiotherapy

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• Tamoxifen (Nolvadex) and paclitaxel (Taxol), which are used to treat breast cancer
• Topotecan (Hycamtin), which is used to treat ovarian and lung cancers
• Vorinostat (Zolinza), which is approved for treatment of cutaneous T-cell lymphoma

Irinotecan (Campath) is another cancer drug that is being studied in combination treatment.

Biologic Drugs (Targeted Therapy)

Traditional chemotherapy drugs can be effective, but because they do not distinguish between healthy and cancerous cells their generalized toxicity can cause severe side effects. Targeted biologic therapies work on a molecular level by blocking specific mechanisms associated with cancer cell growth and division. Because they selectively target cancerous cells, these biologic drugs may induce less severe side effects. In addition, these drugs hold the promise of creating options for more individualized cancer treatment based on a patient's genotype.

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Bevacizumab (Avastin). Bevacizumab (Avastin) is a biologic drug that blocks the growth of blood vessels that feed tumors (a process called angiogenesis). In 2009, the FDA approved bevacizumab for the treatment of glioblastoma in patients whose brain cancer has continued to progress after prior treatment with chemotherapy and radiation. Bevacizumab is the first targeted therapy approved for brain tumors, and the first new treatment for glioblastoma in more than a decade.

Investigational Targeted Therapies. Targeted therapies being tested in clinical trials include:

• Vaccines are among the most promising immunotherapies being tested for slowing the progression of glioblastoma multiforme. Unlike conventional vaccines that are used to prevent disease, these vaccines are used as a cancer treatment. CDX-110 and DCVax-Brain are two such vaccines.
• Tyrosine kinase inhibitor drugs block proteins involved in tumor cell growth and production. Tyrosine kinase inhibitors that target EGFR, [such as erlotinib (Tarceva), imatinib (Gleevac), and gefitinib (Iressa)] are being studied for their effects on brain tumors
• MTOR inhibitors target other enzymes involved in cell growth and replication. Everolimus (RAD-001) is being studied for glioblastoma multiforme and astrocytoma. Everolimus is related to rapamycin (Siroliumus) and tacrolimus (Prograf), which are also being investigated for brain tumor treatment. These drugs are commonly used to suppress the immune system to prevent rejection after organ transplantation.

Review Date: 10/21/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).