Brain Cancer

Brain Cancer

Brain tumors present a particular challenge as the risk of harming healthy brain tissue can severely limit doctors' ability to use surgery, radiation or other treatments. Still, researchers are making steady progress to extend survival and improve patients' quality of life. For example, recent genetic discoveries have led to the identification of distinct sub-types of brain tumors, allowing doctors to personalize care to individual patients and providing potential targets for new treatments.

Expand All +

2016

A new standard of care for high-risk, low-grade gliomas

A new standard of care for high-risk, low-grade gliomas

A federally-funded clinical trial shows that adding a chemotherapy regimen called PCV (procarbazine, CCNU, and vincristine) to radiation therapy slows cancer growth of grade 2 glioma and extends survival by a median of 5 years. Grade 2 gliomas are a rare, slow-growing type of brain tumor that occur most often in young people. As a result of this study, PCV chemotherapy after radiation therapy is now the standard of care for high-risk, low-grade gliomas.

2010

Nine-gene test can predict glioblastoma outcome

Nine-gene test can predict glioblastoma outcome

Researchers identify a set of nine genes that predict the likelihood that a glioblastoma tumor will respond to therapy. The research is used to create a test called DecisionDX-GBM. If validated in future trials, this test has the potential to help doctors choose the most effective therapy for a patient, and could be used to help identify new treatments targeting tumors that do not respond to standard therapies.

2009

Gene mutations linked to tumor aggressiveness

Gene mutations linked to tumor aggressiveness

Scientists learn that brain tumors with an alteration in the IDH1 or IDH2 genes are less aggressive than those without this mutation – a finding that may eventually enable some patients to safely undergo less intense therapy. The study also offers researchers a potential new clue regarding how some tumors form in the first place. The IDH1 and IDH2 genes are located on a pathway that governs the metabolic function of cells, and mutations to these genes may enable abnormal, or cancerous, cells to form. Continued research may guide future development of targeted therapies that interfere with the IDH1 and IDH2 genes in order to halt tumor growth.

2007

Bevacizumab (Avastin) receives FDA approval for glioblastoma

Bevacizumab (Avastin) receives FDA approval for glioblastoma

Two early-stage trials suggest that giving the targeted therapy bevacizumab (Avastin), alone or with the chemotherapy drug irinotecan (Camptosar), may cause tumor shrinkage in patients with glioblastoma whose disease progresses after previous therapy. Based on these findings, the FDA grants accelerated (or early, conditional) approval for bevacizumab to treat glioblastoma. Bevacizumab is an "anti-angiogenic" drug, meaning it works by interfering with the development of blood vessels that tumors need to grow and spread. This marks the first new drug approved for treating brain tumors in a decade, and studies are ongoing to determine if initial treatment with bevacizumab improves overall survival.

2006

Molecular sub-classification of high-grade gliomas predicts prognosis

Molecular sub-classification of high-grade gliomas predicts prognosis

Using advanced molecular classification techniques to examine tumor samples, researchers discover distinct subtypes of high-grade astrocytoma tumors (a form of glioma). They find that each subtype has unique biological features that appear to influence the tumor's behavior and response to certain therapies. The findings pave the way for future research that may help personalize therapy for each tumor and patient, ensuring better outcomes and avoiding unnecessary side effects.

Chemically "illuminating" glioma tumors during surgery postpones recurrence

Chemically "illuminating" glioma tumors during surgery postpones recurrence

The use of 5-aminolevulinic acid, a substance that reacts with and illuminates malignant glioma cells, is shown to improve surgeons' ability to remove tumor tissue. Patients treated with this technique during surgery were significantly less likely to have any tumor growth after six months, compared to those who underwent conventional surgery.

Genetic mutations affect survival for oligodendroglioma

Genetic mutations affect survival for oligodendroglioma

Two studies find that patients with oligodendroglioma tumors (a form of glioma) that lack certain parts of chromosomes 1 and 19 are more sensitive to treatment and have better survival than patients whose tumors are not missing this genetic material. Follow-up data later show that these patients fare much better, living several years longer, when they receive chemotherapy and radiation together, rather than radiation alone. 

2005

Researchers begin mapping the genome of glioblastoma

Researchers begin mapping the genome of glioblastoma

In 2005, the National Cancer Institute and the National Genome Research Institute launch The Cancer Genome Atlas Project, with the goal of mapping the genetic changes involved in glioblastoma and other cancers. In 2008, researchers report the identification of several key mutations – in the ERBB2, NF1 and TP53 genes – that are involved in triggering the development and spread of glioblastoma. It is hoped that these findings will help pinpoint new targets for drug therapies.

MGMT gene alteration predicts response to chemotherapy

MGMT gene alteration predicts response to chemotherapy

Researchers discover that patients with tumors carrying a specific alteration in a gene known as MGMT benefit from temozolomide (Temodar) therapy. The MGMT gene is involved in repairing DNA damage in cancer cells, including damage caused by chemotherapy. Tumors with a genetic alteration that silences this gene are unable to repair the damage caused by temozolomide, and therefore are more susceptible to the drug. On the other hand, tumors without this gene alteration are more resistant to the drug. Researchers continue to explore how to use this and other genetic information to identify which patients are most likely to benefit from chemotherapy.

2003

Chemotherapy "wafer" active against malignant gliomas

Chemotherapy "wafer" active against malignant gliomas

Use of a surgically implanted biodegradable wafer containing the anticancer medication carmustine (BCNU) is found to delay tumor growth and improve overall survival in some patients with gliomas. The wafer provides continuous chemotherapy directly to the tumor site to kill remaining cancer cells and to prevent or slow regrowth of the cancer. Today it is used in patients with recurrent malignant glioma and newly diagnosed glioblastoma, a highly aggressive form of glioma.

1999

New oral chemotherapy drug, temozolomide, increases glioma survival

New oral chemotherapy drug, temozolomide, increases glioma survival

The FDA grants accelerated approval to the oral chemotherapy drug temozolomide (Temodar) to treat anaplastic astrocytoma (a form of high-grade glioma) that recurs following other therapy. The approval is based on early-stage data suggesting that the drug shrinks tumors and is generally well tolerated. In 2005, temozolomide receives full approval for this and other high-grade gliomas, based on data showing that adding the drug to initial radiation therapy increases two-year survival by as much as 50 percent.

1994

National Cancer Institute establishes brain tumor research networks

National Cancer Institute establishes brain tumor research networks

Spurred by emerging understanding about the complexity involved in treating brain tumors and the urgent need for improved therapies, the NCI establishes major brain tumor clinical research networks for adults and children. These groups are comprised of the nation's top brain cancer experts from academic centers who collaborate to evaluate novel therapies for patients with newly diagnosed and recurrent brain tumors.

1993

World Health Organization develops universal system for classifying brain tumors

World Health Organization develops universal system for classifying brain tumors

New international standards for classifying brain and nervous system tumors give doctors and researchers a common language for describing and sharing knowledge about tumor staging and characterization, genetics and treatment. Before this time, many different classification systems were in use around the world, making it difficult to communicate and translate research findings and improve patient care. Experts now reconvene every several years to update the WHO system based on growing knowledge about tumor classification and identification of new sub-types.

Adding chemotherapy to radiation after surgery increases survival for malignant gliomas

Adding chemotherapy to radiation after surgery increases survival for malignant gliomas

A large analysis of the results of several studies shows that adding chemotherapy to radiation therapy helps patients with surgically treated malignant gliomas live longer compared to radiation therapy alone. Randomized trials had previously found that this approach yielded only marginal benefits, yet when the data from these individual studies were assessed in combination, the survival advantage became more pronounced. Despite this result, the still-modest benefits of the combination approach, and the potential for serious side effects, have led to continued debate about its use.

1985

Gamma Knife therapy introduced for treating brain tumors

Gamma Knife therapy introduced for treating brain tumors

After nearly two decades of research, doctors begin using a non-invasive technique known as Gamma Knife to treat certain brain tumors. Also called stereotactic radiosurgery, the approach utilizes precisely focused radiation waves to disrupt cancer cell function and replication, while leaving the brain tissue surrounding the tumor largely untouched. Gamma Knife may also be combined with other forms of cancer therapy, including surgery. The approach continues to be refined today.

1983

MRI greatly improves ability to diagnose and monitor brain tumors

MRI greatly improves ability to diagnose and monitor brain tumors

MRI (magnetic resonance imaging) quickly gains widespread use following its introduction in the mid-1980s, replacing CT scanning as the primary imaging tool for brain tumors. This new technology provides the clearest-ever image of brain tumors and, for the first time, enables doctors to see small, low-grade tumors. Today, refined MRI technologies are widely used to diagnose brain tumors, assess their size and specific location, and non-invasively monitor whether a tumor is responding to therapy. Unlike a CT scan, which uses X-rays to create an image, MRI uses magnetic fields to create detailed pictures of the brain and other tissue.

1977

Radiation established as standard treatment for glioblastoma

Radiation established as standard treatment for glioblastoma

Radiation therapy becomes a mainstay of treatment for glioblastoma, a highly aggressive form of glioma, based on data showing it extends median survival from 3 months to about 9 months. This is the first time a treatment is proven effective against any brain cancer. Today, radiotherapy is used alone or with chemotherapy, both before and after surgery, and in patients with inoperable tumors.

1974

First promising chemotherapy for glioma

First promising chemotherapy for glioma

Researchers report the first data on efficacy of the chemotherapy drug carmustine (BCNU). Unlike other chemotherapy drugs available at the time, carmustine is able to cross the blood-brain barrier and directly attack gliomas. Although this drug can cause significant side effects, the first trials show that it shrinks some tumors. Later trials show that carmustine and other similar drugs also provide a small but significant increase in long-term survival when used with other treatments.

1973

CT scanning provides first clear image of brain tumors

CT scanning provides first clear image of brain tumors

Researchers perform the first computed tomography (CT) scan on a human patient – a woman with a suspected brain tumor. With CT scanning, which uses X-rays to create images of "slices" of the brain, doctors are for the first time able to clearly see tumors arising in the soft tissue of the brain. Over the following decades, this technology continues to be refined and used in combination with other imaging approaches, such as MRI.