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Brain Cancer Chemotherapy
Brain cancer chemotherapy uses powerful drugs to target tumors in the brain. These drugs:
- Are delivered over the course of multiple treatment sessions
- May be administered through several methods, including pills, into the bloodstream through an IV or injected directly into the cerebrospinal fluid
- May be delivered as a single drug or in combination with other brain tumor chemotherapy drugs
All brain cancer chemotherapy has the same goal -- to destroy tumors by disrupting specific cell mechanisms that control tumor growth or multiplication. As part of your personalized treatment plan, you may receive brain tumor chemotherapy alone or in conjunction with other treatments, such as surgery or radiation therapy. At Henry Ford, we employ novel chemotherapy techniques with delivery methods designed to minimize toxicity and side effects.
Brain cancer chemotherapy drugs
There are a number of drugs used in brain tumor chemotherapy, including:
- Alkylating Agents: Alkylating agents work directly on a person's DNA to prevent cancer cells from reproducing.
- Antimetabolites: Antimetabolites are a class of drugs that interfere with DNA and RNA growth
In addition, our brain tumor specialists participate in ongoing clinical trials that explore the effectiveness of specific chemotherapy drugs.
Other therapies include:
- Immunotherapy: Some drugs are used to stimulate a patient's immune system to attack cancer cells. Immunotherapy drugs are currently only used for brain tumors as part of clinical trials.
Mitotic Inhibitors: Mitotic inhibitors are plant alkaloids and other compounds derived from natural products. They can inhibit or stop enzymes from making proteins needed for reproduction of the cancer cells.
- Nitrosoureas: This is a group of anticancer drugs that can cross the blood-brain barrier and interfere with enzymes that help repair DNA. Since these agents are able to travel to the brain, they are used to treat brain tumors.
- Targeting Agents: Targeted cancer therapies are drugs or other substances that block the growth and spread of cancer by interfering with specific molecules involved in tumor growth and progression. Because scientists often call these molecules “molecular targets,” targeted cancer therapies are sometimes called “molecularly targeted drugs,” “molecularly targeted therapies,” or other similar names.
Targeted cancer therapies
Targeted cancer therapies interfere with cancer cell division (proliferation) and spread in different ways. Many of these therapies focus on proteins that are involved in cell signaling pathways, which form a complex communication system that governs basic cellular functions and activities, such as cell division, cell movement, cell responses to specific external stimuli, and even cell death. Targeted therapies of various kinds can:
- Block growth of tumors by blocking growth of blood vessels that supply them oxygen
- Block signals that tell cancer cells to grow and divide
- Cause cancer cell death by delivering toxic substances directly to cancer cells
- Stimulate the immune system to recognize and destroy cancer cells
By focusing on molecular and cellular changes that are specific to cancer, targeted cancer therapies may be more effective than other types of treatment and less harmful to normal cells.Targeted cancer therapies are being studied for use alone, in combination with other targeted therapies, and in combination with other cancer treatments, such as chemotherapy.
Brain cancer therapy: Genetic studies
Every patient’s brain tumor undergoes a special analysis: brain tumor typing. The genetic and pathological testing of your brain tumor allows us to find the right treatment for you.
MGMT (O(6)-methylguanine-DNA methyltransferase) and temozolomide:
Temodar (temozolomide) has been used for decades to treat people who have a glioblastoma multiforme (GBM). However, research has shown that only 40 percent of people respond to Temodar. Given that GBM is an aggressive tumor, the prognosis does not provide time for trial-and-error treatment. To increase the effectiveness of treatment, our team conducts genetic studies:
- This advanced strategy allows us to sooner identify people with tumor resistance to Temodar.
- These studies analyze whether a molecular “switch” on the gene known as MGMT is active or inactive.
- MGMT is a DNA repair marker that allows cells damaged by cancer to repair themselves.
- Unfortunately, this built-in ability to repair cells also makes cancer cells resistant to the beneficial effects of radiation and chemotherapy.
- Research has shown that a person whose MGMT switch is “off” has a significantly greater chance of responding positively to a course of treatment that includes Temodar.
Brain cancer chemotherapy side effects: What is “chemo brain”?
With any treatment, there is the potential for side effects, which can vary depending on the type of therapies you receive. While everyone responds differently, some common side effects of chemotherapy include:
In addition to these, people undergoing brain tumor treatment have noticed other issues involving concentration and memory, which are sometimes collectively referred to as “chemo brain.” Depending on the person, it may be temporary or last for years, seriously affecting quality of life. However, chemo brain is still poorly understood, and the name itself may not be accurate, given that other factors -- such as the brain tumor itself, other medical conditions, sleep issues, nutritional deficiencies, stress or age -- can also cause these types of cognitive issues. At the Hermelin Brain Tumor Center, we work with neuro-psychologists to assess neuro-cognitive challenges and to create an individualized treatment plan to increase memory and focus.
Your Hermelin Brain Tumor Center team will review your personalized treatment plan with you and discuss possible side effects before brain chemotherapy treatment begins, so that you can make informed decisions about your brain tumor care.