History of Brain Cancer

1970

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1980s

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2003

CT Scanning Provides First Clear Image Researchers perform the first computed tomography (CT) scan on a human patient a woman with a suspected brain
of Brain Tumors
tumor. With CT scanning, which uses X-rays to create images of "slices" of the brain, doctors are for the first time able to
clearly see tumors arising in the soft tissue of the brain. Over the following decades, this technology continues to be
refined and used in combination with other imaging approaches, such as MRI.
First Promising Chemotherapy For
Researchers report the first data on efficacy of the chemotherapy drug carmustine (BCNU). Unlike other chemotherapy
Glioma
drugs available at the time, carmustine is able to cross the blood-brain barrier and directly attack gliomas. Although this
drug can cause significant side effects, the first trials show that it shrinks some tumors. Later trials show that carmustine
and other similar drugs also provide a small but significant increase in long-term survival when used with other
treatments.
Radiation Established As Standard
Radiation therapy becomes a mainstay of treatment for glioblastoma, a highly aggressive form of glioma, based on data
Treatment For Glioblastoma
showing it extends median survival from 3 months to about 9 months. This is the first time a treatment is proven effective
against any brain cancer. Today, radiotherapy is used alone or with chemotherapy, both before and after surgery, and in
patients with inoperable tumors.
MRI Greatly Improves Ability To
MRI (magnetic resonance imaging) quickly gains widespread use following its introduction in the mid-1980s, replacing CT
Diagnose And Monitor Brain Tumors
scanning as the primary imaging tool for brain tumors. This new technology provides the clearest-ever image of brain
tumors and, for the first time, enables doctors to see small, low-grade tumors. Today, refined MRI technologies are widely
used to diagnose brain tumors, assess their size and specific location, and non-invasively monitor whether a tumor is
responding to therapy. Unlike a CT scan, which uses X-rays to create an image, MRI uses magnetic fields to create
detailed pictures of the brain and other tissue.
Gamma Knife Therapy Introduced For
After nearly two decades of research, doctors begin using a non-invasive technique known as Gamma Knife to treat
Treating Brain Tumors
certain brain tumors. Also called stereotactic radiosurgery, the approach utilizes precisely focused radiation waves to
disrupt cancer cell function and replication, while leaving the brain tissue surrounding the tumor largely untouched.
Gamma Knife may also be combined with other forms of cancer therapy, including surgery. The approach continues to be
refined today.
Adding Chemotherapy To Radiation After A large analysis of the results of several studies shows that adding chemotherapy to radiation therapy helps patients with
Surgery Increases Survival For Malignant surgically treated malignant gliomas live longer compared to radiation therapy alone. Randomized trials had previously
Gliomas
found that this approach yielded only marginal benefits, yet when the data from these individual studies were assessed in
combination, the survival advantage became more pronounced. Despite this result, the still-modest benefits of the
combination approach, and the potential for serious side effects, have led to continued debate about its use.
World Health Organization Develops
New international standards for classifying brain and nervous system tumors give doctors and researchers a common
Universal System For Classifying Brain language for describing and sharing knowledge about tumor staging and characterization, genetics and treatment. Before
Tumors
this time, many different classification systems were in use around the world, making it difficult to communicate and
translate research findings and improve patient care. Experts now reconvene every several years to update the WHO
system based on growing knowledge about tumor classification and identification of new sub-types.
National Cancer Institute Establishes
Spurred by emerging understanding about the complexity involved in treating brain tumors and the urgent need for
Brain Tumor Research Networks
improved therapies, the NCI establishes major brain tumor clinical research networks for adults and children. These
groups are comprised of the nation's top brain cancer experts from academic centers who collaborate to evaluate novel
therapies for patients with newly diagnosed and recurrent brain tumors.
New Oral Chemotherapy Drug,
The FDA grants accelerated approval to the oral chemotherapy drug temozolomide (Temodar) to treat anaplastic
Temozolomide, Increases Glioma
astrocytoma (a form of high-grade glioma) that recurs following other therapy. The approval is based on early-stage data
Survival
suggesting that the drug shrinks tumors and is generally well tolerated. In 2005, temozolomide receives full approval for
this and other high-grade gliomas, based on data showing that adding the drug to initial radiation therapy increases twoyear survival by as much as 50 percent.
Chemotherapy "Wafer" Active Against
Use of a surgically implanted biodegradable wafer containing the anticancer medication carmustine (BCNU) is found to
Malignant Gliomas
delay tumor growth and improve overall survival in some patients with gliomas. The wafer provides continuous
chemotherapy directly to the tumor site to kill remaining cancer cells and to prevent or slow regrowth of the cancer. Today
it is used in patients with recurrent malignant glioma and newly diagnosed glioblastoma, a highly aggressive form of
glioma.

History of Brain Cancer

2005

2005, 2008

2006, 2013

2006
2006

2008

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2010

MGMT Gene Alteration Predicts

Response To Chemotherapy

Researchers discover that patients with tumors carrying a specific alteration in a gene known as MGMT benefit from
temozolomide (Temodar) therapy. The MGMT gene is involved in repairing DNA damage in cancer cells, including
damage caused by chemotherapy. Tumors with a genetic alteration that silences this gene are unable to repair the
damage caused by temozolomide, and therefore are more susceptible to the drug. On the other hand, tumors without this
gene alteration are more resistant to the drug. Researchers continue to explore how to use this and other genetic
information to identify which patients are most likely to benefit from chemotherapy.
Researchers Begin Mapping The
In 2005, the National Cancer Institute and the National Genome Research Institute launch The Cancer Genome Atlas
Genome Of Glioblastoma
Project, with the goal of mapping the genetic changes involved in glioblastoma and other cancers. In 2008, researchers
report the identification of several key mutations in the ERBB2, NF1 and TP53 genes that are involved in triggering
the development and spread of glioblastoma. It is hoped that these findings will help pinpoint new targets for drug
therapies.
Genetic Mutations Affect Survival For
Two studies find that patients with oligodendroglioma tumors (a form of glioma) that lack certain parts of chromosomes 1
Oligodendroglioma
and 19 are more sensitive to treatment and have better survival than patients whose tumors are not missing this genetic
material. Follow-up data later show that these patients fare much better, living several years longer, when they receive
chemotherapy and radiation together, rather than radiation alone.
Chemically "Illuminating" Glioma Tumors The use of 5-aminolevulinic acid, a substance that reacts with and illuminates malignant glioma cells, is shown to improve
During Surgery Postpones Recurrence surgeons' ability to remove tumor tissue. Patients treated with this technique during surgery were significantly less likely to
have any tumor growth after six months, compared to those who underwent conventional surgery.
Molecular Sub-Classification Of HighUsing advanced molecular classification techniques to examine tumor samples, researchers discover distinct subtypes of
Grade Gliomas Predicts Prognosis
high-grade astrocytoma tumors (a form of glioma). They find that each subtype has unique biological features that appear
to influence the tumor's behavior and response to certain therapies. The findings pave the way for future research that
may help personalize therapy for each tumor and patient, ensuring better outcomes and avoiding unnecessary side
effects.
Bevacizumab (Avastin) Receives FDA
Two early-stage trials suggest that giving the targeted therapy bevacizumab (Avastin), alone or with the chemotherapy
Approval For Glioblastoma
drug irinotecan (Camptosar), may cause tumor shrinkage in patients with glioblastoma whose disease progresses after
previous therapy. Based on these findings, the FDA grants accelerated (or early, conditional) approval for bevacizumab to
treat glioblastoma. Bevacizumab is an "anti-angiogenic" drug, meaning it works by interfering with the development of
blood vessels that tumors need to grow and spread. This marks the first new drug approved for treating brain tumors in a
decade, and studies are ongoing to determine if initial treatment with bevacizumab improves overall survival.
Gene Mutations Linked To Tumor
Scientists learn that brain tumors with an alteration in the IDH1 or IDH2 genes are less aggressive than those without this
Aggressiveness
mutation a finding that may eventually enable some patients to safely undergo less intense therapy. The study also
offers researchers a potential new clue regarding how some tumors form in the first place. The IDH1 and IDH2 genes are
located on a pathway that governs the metabolic function of cells, and mutations to these genes may enable abnormal, or
cancerous, cells to form. Continued research may guide future development of targeted therapies that interfere with the
IDH1 and IDH2 genes in order to halt tumor growth.
Nine-Gene Test Can Predict
Researchers identify a set of nine genes that predict the likelihood that a glioblastoma tumor will respond to therapy. The
Glioblastoma Outcome
research is used to create a test called DecisionDX-GBM. If validated in future trials, this test has the potential to help
doctors choose the most effective therapy for a patient, and could be used to help identify new treatments targeting
tumors that do not respond to standard therapies.