Table 1 FDA-approved agents for the treatment of brain tumor (Adapted from current treatments for brain tumors, National Brain Tumor Society, The United States) [18, 19]
From: Antioxidants in brain tumors: current therapeutic significance and future prospects
Agents | Manufacturers and year of approval | Drug types | Drug uses | Mechanisms | Side effects |
|---|---|---|---|---|---|
Temozolomide (TMZ) | Celon Laboratories Ltd. 2005 | Nonspecific alkylating agent | All high-grade gliomas (HGG) (SOC) | Causes mismatch repair in DNA via methylation of guanine at the O6 position | Thrombocytopenia (12%), leukopenia (7%), neutropenia (7%), hematologic toxicity (16%), |
Lomustine (CCNU) | Bristol-Myers Squibb Co. 1976 | Nonspecific alkylating agent | Recurrent HGG | Facilitates crosslinking of DNA and RNA in dividing cells triggering cell death | Hematologic toxicity (49.7%) |
Carmustine (BCNU) | Bristol-Myers Squibb Co. 1977 | Nonspecific alkylating agent | Recurrent HGG | Facilitates crosslinking of DNA and RNA in dividing cells; binds to and modifies GR | Ocular toxicity (> 10%), pulmonary toxicity (< 30%), and bone marrow suppression (> 10%) |
BCNU wafer implants | Eisai Inc. 1996 & 2003 | Nonspecific alkylating agent | Recurrent and new HGG | Causes the crosslinking of DNA and RNA in dividing cells; binds to and modifies GR | Intracrania infection (1–10%), cerebral edema (1–10%), wound-healing complications (12%), |
Bevacizumab (BVZ) | Genentech, Inc. 2009 | Targeted therapeutic antibody | Recurrent HGG | Binds to and inhibits the VEGF protein in tumor cells | Thromboembolic events (3.2–11.9%), hypertension (5.5–11.4%), gastrointestinal perforation (1.5–5.4%), wound-healing complications (0.8–3.3%), cerebral bleeding (2–5.3%), and proteinuria (2.7–11.4%) |
Optune device (TTFields) | Novocure. 2011 & 2015. | Low-intensity (1–3 V/cm), intermediate-frequency (200 kHz) alternating electric fields | Recurrent and new HGG | Disrupts tumor cell mitosis | Seizures (7%) and skin toxicity (43%) |