Brain and spinal tumours

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Research in brain and spinal cord tumours

We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better practices that will help prevent, find and treat brain and spinal cord tumours. They are also looking for ways to improve the quality of life of people with brain and spinal cord tumours.

The following is a selection of research showing promise for brain and spinal cord tumours. We’ve included information from PubMed, which is the research database of the National Library of Medicine. Each research article in PubMed has an identity number (called a PMID) that links to a brief overview (called an abstract).

Preventing brain and spinal cord tumours

Some substances or behaviours may prevent brain and spinal cord tumours or lower your risk of developing them. The following is noteworthy research into ways to prevent brain and spinal cord tumours or lower your risk.

Having allergies seems to lower the risk of developing brain tumours such as gliomas and meningioma. Researchers do not yet fully understand why there is a connection between allergies and brain tumours, but it appears to be linked to antibodies of the varicella zoster virus (also called Human herpesvirus 3 or HHV-3), which causes chicken pox. More research into allergies may help find ways to lower the risk for brain tumours (International Journal of Cancer, PMID 24127236; Cancer Medicine, PMID 26972449; Cancer Epidemiology, Biomarkers and Prevention, PMID 26908595).

Find out more about research in cancer prevention.

Diagnosis and prognosis

A key area of research looks at better ways to diagnose and stage brain and spinal cord tumours. Researchers are also trying to find ways to help doctors predict a prognosis (the probability that the cancer can be successfully treated or that it will come back after treatment). The following is noteworthy research into diagnosis and prognosis.

O6-methylguanine-DNA methyltransferase (MGMT) is an enzyme that repairs DNA in cells. Researchers are looking at MGMT as a prognostic factor for glioblastomas (also called glioblastoma multiforme or GBM). Some glioblastomas have less MGMT than normal because the DNA that controls the production of the enzyme has been changed (it has been methylated). MGMT methylation (which turns off the ability of the cell to repair DNA damage) is associated with a better prognosis because it limits the ability of cancer cells to grow after they are damaged by chemotherapy. It can also help doctors find out which people 65 years of age and older with a glioblastoma are more likely to respond better to certain treatments such as temozolomide (Temodal). In this way, the MGMT status of a tumour can help doctors plan treatment (Journal of Neuro-oncology, PMID 24395350, PMID 24178440; PloS One, PMID 24454798, PMID 26447477; Oncology Letters, PMID 26788176; Journal of Clinical Neuroscience, PMID 26249244; Clinical Cancer Research, PMID 25655102).

Isocitrate dehydrogenase (IDH) gene mutations may help doctors predict a prognosis for people with gliomas. Recent studies found that IDH gene mutations in gliomas are linked with longer survival. IDH gene mutations are often found in tumours that had low amounts of MGMT and deletions of chromosomes 1p and 19q. These features are also linked with longer survival in people with gliomas. IDH gene mutations may help doctors find out which people are more likely to respond better to certain treatments (Neuro-oncology, PMID 24305719, PMID 24366912; PMID 24470545; Journal of Neuropathology and Experimental Neurology, PMID 25668564; Journal of Clinical Oncology, PMID 24516018; Journal of Neuro-oncology, PMID 24748470; Clinical Neurology and Neurosurgery, PMID 27764705).

Find out more about research in diagnosis and prognosis.

Treatment

Researchers are looking for new ways to improve treatment for brain and spinal cord tumours. Advances in cancer treatment and new ways to manage the side effects from treatment have improved the outlook and quality of life for many people with cancer. The following is noteworthy research into treatment for brain and spinal cord tumours.

Surgery

Researchers are looking into different imaging tools that may be helpful with surgery for brain and spinal cord tumours.

Intra-operative imaging techniques are tools that help doctors see inside the body during surgery. Researchers are studying these techniques to see if they can be used to help doctors plan treatment and guide them during surgery for brain and spinal cord cancer. Contrast-enhanced ultrasound is one intra-operative imaging technique that researchers are studying (Neurosurgical Focus, PMID 26926064, PMID 26926065; BioMed Research International, PMID 27069921).

Diffusion tensor imaging (DTI) is a special type of MRI scan that allows a doctor to see bundles of nerve fibres that are not visible with regular MRI. Identifying these nerve fibres may help doctors plan surgery to remove a glioma and lower the risk that the nerve fibres will be damaged during surgery. Avoiding damage to the nerve fibres can help prevent side effects after surgery. DTI may also help doctors accurately map a glioblastoma. This helps them plan and deliver radiation therapy so that they can avoid treating healthy brain tissue with radiation (International Journal of Radiation Oncology, Biology, Physics, PMID 27681767; Neuro-oncology, PMID 26117712; Journal of Magnetic Resonance Imaging, PMID 24399480).

Find out more about research in cancer surgery.

Radiation therapy

Radiation therapy is a standard treatment for many types of brain tumours. Researchers are studying new types of radiation therapy to treat brain and spinal cord tumours.

Proton therapy uses protons (positively charged particles) to treat cancer. Protons release more energy after reaching a certain distance and then stop, causing the least amount of damage to nearby normal tissues. Clinical trials are looking at using proton therapy as a way to reduce side effects caused by damage to healthy tissue around the tumour. Most of the research into proton therapy is being done in children with brain tumours (Cancer, PMID 25585890; Practical Radiation Oncology, PMID 25413424; Radiation Oncology, PMID 26112360).

Find out more about research in radiation therapy.

Targeted therapy

Targeted therapy drugs target specific molecules (usually proteins) that cause cancer cells to grow. Some targeted therapies are currently used to treat brain and spinal cord tumours. Researchers are studying the following types of targeted therapy drugs to find out if they are useful in treating brain and spinal cord tumours.

Tyrosine kinase inhibitors block a specific enzyme (called tyrosine kinase) that helps send signals within cells. When this enzyme is blocked, the cells stop growing and dividing. Researchers are currently doing clinical trials to study the following tyrosine kinase inhibitors as a treatment for certain brain tumours:

mTOR inhibitors slow or stop cancer growth by blocking the mTOR protein. Everolimus (Afinitor) is an mTOR inhibitor used to treat certain brain tumours. Voxtalisib (XL765, SAR245409) is another mTOR inhibitor that researchers are studying in clinical trials to treat high-grade gliomas (Neuro-oncology, PMID 26019185).

Histone deacetylase (HDAC) inhibitors slow or stop the growth of cancer cells by blocking HDAC. Panobinostat (Farydak) is an HDAC inhibitor that can improve the effectiveness of certain chemotherapy drugs or radiation therapy by making cancer cells more sensitive to these treatments. Researchers are studying panobinostat in clinical trials to treat certain brain tumours (Neuro-oncology, PMID 25572329; Journal of Neuro-oncology, PMID 26821711).

Epidermal growth factor receptors (EGFRs) send signals that promote the growth and survival of cells. Researchers are studying nimotuzumab (TheraCIM), which is a monoclonal antibody that targets the EGFR on cancer cells. Nimotuzumab blocks these receptors and so cuts off the signal pathway and causes the cancer cells to die. A study found that nimotuzumab given with radiation therapy and temozolomide (Temodal) is an effective treatment for newly diagnosed glioblastoma (European Journal of Cancer, PMID 25616647; Asia-Pacific Journal of Clinical Oncology, PMID 24571331). Afatinib (Giotrif) is a tyrosine kinase inhibitor that also targets EGFRs. Researchers are studying afatinib in people with recurrent glioblastoma (Neuro-oncology, PMID 25140039).

Veliparib (ABT-888) is a PARP inhibitor, which means that it stops the action of the enzyme poly (ADP-ribose) polymerase. This type of drug kills cancer cells by preventing them from repairing damage and possibly making them more sensitive to anticancer treatments. Researchers are studying veliparib in clinical trials to prevent or minimize temozolomide resistance in people with glioblastoma (Journal of Neuro-oncology, PMID 26508094).

Anti-angiogenesis drugs slow or stop the growth of new blood vessels. Cutting off the blood supply will starve a tumour of oxygen and nutrients, which it needs to grow. Bevacizumab (Avastin) is an anti-angiogenesis drug approved to treat certain brain and spinal cord tumours. Recently, 2 large randomized studies found that adding bevacizumab to current standard treatment did not improve survival for glioblastoma. Researchers are also studying cilengitide (EMD 121974), which is a drug that inhibits the growth of new blood vessels and promotes the normal process of cell death (called apoptosis). It is showing promise in clinical trials for treating both newly diagnosed and recurrent glioblastoma (Lancet Oncology, PMID 25163906; Neuro-oncology, PMID 25762461, PMID 26008604). Researchers are also looking at other anti-angiogenesis drugs, including enzastaurin (LY317615, to treat brain and spinal cord tumours (Journal of Neuro-oncology, PMID 26643807).

Find more about research in targeted therapy.

Cancer vaccines

Therapeutic cancer vaccines stimulate the body to produce an immune response against cancer cells. Currently there are no therapeutic cancer vaccines approved for use with any type of brain or spinal cord cancer. Researchers are looking into different therapeutic cancer vaccines to treat brain tumours, particularly gliomas (Neuro-oncology, PMID 25586468; International Journal of Cancer, PMID 27170523; Journal of Neurosurgery, PMID 26252465; Journal of Neuro-oncology, PMID 25366363; Human Gene Therapy: Clinical Development, PMID 27314913, PMID 28253733; Cancer Immunology, Immunotherapy, PMID 27576783; Clinical Cancer Research, PMID 28411277).

Find out more about research in immunotherapy.

Other treatments

Researchers are looking at the following as possible treatments for brain and spinal cord tumours.

Electric field therapy is a new kind of treatment that uses electric currents to interfere with cell division and prevent cancer cells from growing. To treat brain tumours, electrodes are placed on a person’s head and wires from a battery pack are connected to the electrodes to deliver an electric current. Studies show that electric field therapy is as effective as chemotherapy in treating recurrent glioblastoma. People who received electric field therapy also had fewer side effects than those who received chemotherapy. A recent randomized clinical trial suggests that electric field therapy improves outcomes by a small amount when it is added to the standard therapy. The main side effect from electric field therapy was skin irritation from the electrodes (Cancer Medicine, PMID 25620708; Expert Review of Medical Devices, PMID 26513694; Neurosurgical Focus, PMID 25727223; JAMA, PMID 26670971). Electric field therapy is very expensive, which may be why it is not used more often.

Laser interstitial thermal therapy (LITT) is a type of ablation treatment. The doctor places a probe in the tumour. The probe gives off light energy. Light energy is changed into heat energy in the tumour, which destroys cancer cells. Studies show that LITT is effective in treating gliomas that are difficult to reach and remove with surgery, brain metastasis that is resistant to treatment and radiation necrosis. They also show that LITT may temporarily disrupt the blood-brain barrier, which means that drugs could easily reach the brain during this time period (PloS One, PMID 26910903; Expert Review of Neurotherapeutics, PMID 26731270; Neurosurgical Focus, PMID 27690660, PMID 27690649, PMID 27690659, PMID 27690658).

Zika virus attacks developing brain cells, causing birth defects in an unborn child. Early research studies show that the virus selectively kills glioblastoma stem cells. This research is in the very early stages, but it suggests that Zika virus may be a promising area of research into developing a cancer vaccine to treat brain tumours (Journal of Experimental Medicine, PMID 28874392).

Learn more about cancer research

Researchers continue to try to find out more about brain and spinal cord cancer. Clinical trials are research studies that test new ways to prevent, detect, treat or manage brain and spinal cord cancer. Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for brain and spinal cord cancer were first shown to be effective through clinical trials.

Find out more about cancer research and clinical trials.

monoclonal antibody

A substance that can find and bind to a particular target molecule (antigen) on a cancer cell.

Monoclonal antibodies can interfere with a cell’s function or can be used to carry drugs, toxins or radioactive material directly to a tumour.

ablation

A procedure that removes or destroys cells, tissues or organs.

Ablation may be done by surgery, chemicals, heat, high-frequency electrical current, radiofrequency waves, lasers or other methods.

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