Central nervous system (CNS) tumors, although rare, represent a group of neoplasms that have a disproportionate morbidity and mortality. Despite advances in our understanding of tumor pathogenesis coupled with improvements in therapeutic options, overall survival for primary brain tumors remains dismal. Although challenging, newer approaches such as brachytherapy, immunotherapy, and electric field generators are currently being evaluated in the clinical setting with promising results. The field of immunotherapy in neurooncology is still in its infancy, but several advances have already been made, including the development of tumor vaccines, utilization of immune checkpoint inhibitors, and activation of tumor dendritic cells to stimulate the host’s immune system. Recent advances in noninvasive electric fields have been applied to the treatment of glioblastoma multiforme (GBM) with encouraging clinical outcome. In this chapter, we will review the latest advances in the treatment of glioblastoma multiforme with a focus on immunotherapy.
Part of the book: New Approaches to the Management of Primary and Secondary CNS Tumors
Metastatic brain tumors (MBTs) are the most common intracranial tumor and occur in up to 40% of patients with certain cancer diagnoses. The most common and frequent primary locations are cancers originating from the lung, breast, kidney, gastrointestinal tract or skin, and also may arising from any part of the body. Treatment for brain metastasis management includes surgery, whole brain radiotherapy (WBRT), stereotactic radiosurgery (SRS), and chemotherapy. Standard treatment for MBTs includes surgery and SRS which offer the best outcomes, while the WBRT is still an important treatment option for patients who cannot tolerate surgery and SRS or patients with multiple brain metastases. Newer approaches such as immunotherapy and molecularly targeted therapy (e.g., small molecules and monoclonal antibodies) are currently being evaluated for the treatment of MBTs. In this chapter, we will review current available treatments for MBTs and discuss treatments that are undergoing active investigation.
Part of the book: Brain and Spinal Tumors