Although surgery is usually the chosen treatment for brain tumors, there are times when the brain tumor cannot be operated on or surgery cannot completely remove all of the tumor.

When surgery is not a choice or when surgery cannot remove all of the tumor, other treatment options must be considered. Chemotherapy and radiation may be used to shrink and potentially cure the tumor. Or, these treatments may be used to prolong survival and decrease the severity of symptoms caused by the brain tumor.

Other treatments may also be used for brain tumors. These are often chosen based on the type of brain tumor. They may be used alone or in combination with traditional chemotherapy and/or radiation.

These other types of treatment include:

  • Targeted therapy
  • Immunotherapy

Targeted therapy uses different biological pathways to interfere with the ability of cancer cells to grow, divide, and/or spread.

Examples of these types of treatments include:

  • Enzyme inhibitors—interfere with the cancer cells’ ability to grow and divide
  • Apoptosis inducers—target cancer cells to cause their death
  • Angiogenesis inhibitors—interfere with the cancer cells’ ability to create new blood vessels, which they need in order to continue growing
    • There are a number of anti-angiogenic agents being used. They include antibodies against the factors secreted by cells to promote new blood vessel growth, such as bevacizumab (Avastin).

Immunotherapies are treatments that improve the cancer-fighting ability of the immune system or administer immune cells in order to fight cancer. These treatments include:

  • Monoclonal antibodies—Large quantities of lab-produced antibodies are given to the patient. These antibodies interfere with basic cell processes and stop the cancer cells from growing, dividing, and interacting with other cancer cells. The antibodies' role is limited by their ability to cross the blood-brain barrier or blood-tumor barrier.
  • Cancer vaccines—Pieces of cancer cells or proteins modeled from cancer cells are given to the patient. This is done to activate the patient’s immune system to recognize and attack cancer cells.
  • Gene therapy—Gene therapy may attempt to change the patient’s own genes to make them more successful at battling cancer cells. Or, this form of therapy may change the cancer cells' genes to make the cancer more vulnerable to destruction by other forms of treatment.
  • Cytokines—These immune system substances may boost the effectiveness of other types of treatments, decrease treatment side effects, and improve the immune system’s ability to fight against cancer.