Immunotherapy for brain and spinal cord tumours

Immunotherapy helps to strengthen or restore the immune system’s ability to fight cancer. This works to kill cancer cells and stop cancer cells from growing and spreading.

Immunotherapy is sometimes used to treat brain and spinal cord tumours. If you have immunotherapy, your healthcare team will use what they know about the cancer and about your health to plan the drugs, doses and schedules.

Immunotherapy may be the only treatment you have or it may be used along with other treatments. You may have immunotherapy to:

• treat cancer that doesn’t respond to other treatments (refractory) or that comes back after treatment (recurrent)

Monoclonal antibodies (mAbs) are made in the lab. Like the antibodies that your immune system makes, their job is to trigger an immune system reaction. Some monoclonal antibodies work by finding a specific antigen (such as a protein) on a cancer cell and then attaching to it. Your immune system then knows to attack and destroy those cells.

Bevacizumab (Avastin and biosimilars) is the monoclonal antibody drug used to treat brain and spinal cord tumours.

Bevacizumab targets a substance called vascular endothelial growth factor (VEGF) that helps cells form new blood vessels to carry oxygen and nutrients. The drug attaches to tumour cells and prevents them from forming new blood vessels.

Bevacizumab is given with lomustine (a chemotherapy drug) to treat glioblastoma that has come back after treatment or that does not respond to treatment. It may also be used to treat other types of brain and spinal cord tumours. It is given by IV infusion (through a vein), usually every 2 weeks.

Side effects of monoclonal antibodies will depend mainly on the type of drug or combination of drugs, the dose, how it’s given and your overall health. Tell your healthcare team if you have side effects that you think are from monoclonal antibodies. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Bevacizumab may cause these side effects:

• fatigue
• low blood cell counts
• diarrhea
• abdominal pain
• high blood pressure
• black, tarry stools (poop)
• peripheral neuropathy
• headache
• infection
• heart problems
• bowel perforation

All drugs, including those used to treat cancer, are approved for use in Canada by Health Canada. If a drug is mentioned on cancer.ca, it means that Health Canada has approved the drug and pharmaceutical companies sell it in Canada. It does not mean that the drug is offered everywhere in Canada.

Paying for drugs is the responsibility of provincial and territorial health departments. Each health department makes its own decisions about which drugs to cover (pay for) in that province or territory. This means that a drug may be covered in one province, but not in others.

Your oncologist will talk to you about different drug treatments and what is available through your provincial or territorial drug program.

Find out more about immunotherapy. To make the decisions that are right for you, ask your healthcare team questions about immunotherapy.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.