Targeted therapy for brain and spinal cord tumours

Targeted therapy is sometimes used to treat brain and spinal cord tumours. It uses drugs to target specific molecules (such as proteins) on cancer cells or inside them. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells and limit harm to normal cells. Targeted therapy may also be called molecular targeted therapy.

You may have targeted therapy:

• to destroy cancer cells left behind after surgery and reduce the risk that the cancer will come back (recur) (called adjuvant therapy)
• when previous treatment has failed
• to treat some brain and spinal cord tumours that have recurred
• in combination with chemotherapy

Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of targeted therapy. You may also receive other treatments.

Targeted therapy drugs used are:

Bevacizumab (Avastin) is a monoclonal antibody that targets a substance called vascular endothelial growth factor (VEGF) that helps cells form new blood vessels to carry oxygen and nutrients. It attaches to tumour cells and prevents them from forming new blood vessels. Bevacizumab, given with lomustine, is used to treat glioblastoma (GBM) and may be used to treat other types of brain and spinal cord tumours. It is given by IV infusion, usually every 2 weeks.

Everolimus (Afinitor) works by blocking a cell protein known as mTOR, which normally helps cells grow and divide into new cells. It may be used to treat subependymal giant cell astrocytomas that can’t be completely removed by surgery. Everolimus is a pill taken once a day.

Side effects can happen with any type of treatment for brain and spinal cord tumours, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

Targeted therapy doesn’t usually damage healthy cells, so there are usually fewer and less severe side effects than with chemotherapy and radiation therapy. Chemotherapy and radiation therapy can damage healthy cells along with cancer cells.

If you develop side effects, they can happen any time during, immediately after or a few days or weeks after targeted therapy. Sometimes late side effects develop months or years after targeted therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of targeted therapy will depend mainly on the type of drug or combination of drugs, the dose, how it’s given and your overall health.

Some common side effects of targeted therapy for brain and spinal cord tumours are:

• fatigue
• headache
• sore mouth
• loss of appetite
• nausea
• diarrhea
• low white blood cell count (increases risk of infection)
• increased blood pressure
• skin problems, such as rash
• fluid buildup (most often in the legs)

Tell your healthcare team if you have these side effects or others you think might be from targeted therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

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

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