# Brain and spinal cord tumours (all types)

Source: https://onco.cc/cancers/brain-tumours/  
OnCo record `brain-tumours` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Brain and spinal cord tumours range from slow-growing meningiomas and low-grade gliomas to glioblastoma, the commonest malignant brain tumour in adults, and a distinct set of childhood tumours such as medulloblastoma and diffuse midline glioma. Molecular markers now define them, and treatment is surgery, radiotherapy and, for some, drugs chosen by those markers.

## Summary

Tumours of the brain and spinal cord are classified by the WHO by cell type and, since 2016 and more so in 2021, by molecular markers such as IDH mutation, 1p/19q codeletion, H3 K27 alteration and MGMT methylation. In adults the main groups are gliomas (from IDH-mutant low-grade astrocytomas and oligodendrogliomas to IDH-wildtype glioblastoma), meningiomas, pituitary tumours and primary CNS lymphoma; in children, medulloblastoma, ependymoma, low-grade gliomas, diffuse midline glioma and rare embryonal tumours dominate. Surgery as complete as function allows, radiotherapy and temozolomide remain the backbone; targeted drugs such as vorasidenib for IDH-mutant glioma and BRAF and MEK inhibitors for BRAF-altered paediatric glioma are the first molecular therapies to change practice. The blood-brain barrier and the impossibility of wide margins make these among the hardest cancers to treat, which is why the subtype pages give the detail.

## Fields

- Kind: Cancer
- Last checked: 2026-09-04
- Also known as: Brain Tumors; Brain tumors; CNS tumours; Central nervous system tumours; Brain cancer
- Tags: umbrella
- Group: central nervous system
- Burden: About 308,000 new cases and 251,000 deaths worldwide in 2020 (GLOBOCAN) for brain and central nervous system cancers; the leading cause of cancer death in children in many high-income countries.
- Subtypes: Glioblastoma (IDH-wildtype); IDH-mutant astrocytoma and oligodendroglioma; Paediatric low-grade glioma; Diffuse midline glioma (DIPG); Medulloblastoma; Ependymoma; Atypical teratoid/rhabdoid tumour; Craniopharyngioma; Meningioma; Primary CNS lymphoma; Brain metastases (from other cancers); Paediatric high-grade glioma; Vestibular schwannoma; Spinal cord tumours; CNS germ cell tumours; Pituitary tumours
- Biomarkers: IDH1/IDH2 mutation; 1p/19q codeletion; MGMT promoter methylation; H3 K27M alteration; BRAF V600E and KIAA1549::BRAF fusion in paediatric glioma; Molecular subgroups of medulloblastoma (WNT, SHH, group 3, group 4)

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/brain-tumours/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/brain-tumours/#overview [15 subtypes]
- Types and stages (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/brain-tumours/#what-it-is [31 subtypes]
- Symptoms and diagnosis (on the hub): How this cancer shows itself, how the diagnosis is confirmed, and the biomarkers clinicians test for. https://onco.cc/cancers/brain-tumours/#finding-it [6 biomarkers]
- Treatment (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/brain-tumours/#treating-it [3 settings, 1 regimen, 1 decision with options]
- Trials and papers (own page): Trials recruiting now, the landmark trials, the trials held by this cancer's subtypes, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/brain-tumours/evidence/ [40 trials, 106 trials in the subtypes, 3 milestones]
- Biology and targets (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/brain-tumours/#science [8 targets]
- Countries and centres (own page): Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes. https://onco.cc/cancers/brain-tumours/where-you-are/ [217 centres in the subtypes]
- Decisions and support (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/brain-tumours/#living-with-it [15 questions, 4 red cards]
- Pipeline and open problems (own page): Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/brain-tumours/coming/ [7 medicines, 72 medicines in the subtypes, 40 trials, 3 open problems]
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/brain-tumours/data/ [89 connected records]

## Standard of care

- Glioblastoma: Maximal safe resection, radiotherapy with concurrent and adjuvant temozolomide (Stupp regimen), tumour-treating fields as an option. See the glioblastoma page. ([Temozolomide](https://onco.cc/drugs/temozolomide/))
- IDH-mutant low-grade glioma: Surgery, then observation or vorasidenib for grade 2 tumours, radiotherapy and chemotherapy for higher risk. ([Vorasidenib](https://onco.cc/drugs/vorasidenib/))
- Childhood tumours: Risk-adapted surgery, radiotherapy and chemotherapy by subgroup; BRAF and MEK inhibitors for BRAF-altered low-grade glioma. See the medulloblastoma, ependymoma and DIPG pages. ([Dabrafenib](https://onco.cc/drugs/dabrafenib/), [Trametinib](https://onco.cc/drugs/trametinib/))

## Open problems

- Drugs rarely cross the blood-brain barrier at useful concentrations.
- Median survival in diffuse midline glioma is still about a year.
- Cognitive late effects of radiotherapy in children.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Brain_tumor
- NCI: Brain tumors: https://www.cancer.gov/types/brain
- GLOBOCAN 2020 (Sung 2021): https://doi.org/10.3322/caac.21660

## Connected records

- cancers: [Adolescent and young adult cancers (ages 15 to 39)](https://onco.cc/cancers/aya-cancers/), [Astrocytoma, IDH-mutant (grades 2 to 4)](https://onco.cc/cancers/idh-mutant-astrocytoma/), [Atypical teratoid/rhabdoid tumour (ATRT)](https://onco.cc/cancers/atrt/), [Brain metastases (secondary brain tumours)](https://onco.cc/cancers/secondary-brain-tumours/), [Central nervous system germ cell tumours (germinoma and non-germinomatous)](https://onco.cc/cancers/cns-germ-cell-tumours/), [Choroid plexus carcinoma](https://onco.cc/cancers/choroid-plexus-carcinoma/), [Craniopharyngioma](https://onco.cc/cancers/craniopharyngioma/), [Diffuse midline glioma, H3 K27-altered (including DIPG)](https://onco.cc/cancers/dipg-dmg/), [Ependymoma](https://onco.cc/cancers/ependymoma/), [Glioma & glioblastoma](https://onco.cc/cancers/glioblastoma/), [Medulloblastoma](https://onco.cc/cancers/medulloblastoma/), [Meningioma](https://onco.cc/cancers/meningioma/), [Oligodendroglioma, IDH-mutant and 1p/19q-codeleted](https://onco.cc/cancers/oligodendroglioma/), [Optic pathway glioma](https://onco.cc/cancers/optic-pathway-glioma/), [Paediatric high-grade glioma (excluding diffuse midline glioma)](https://onco.cc/cancers/paediatric-high-grade-glioma/), [Paediatric low-grade glioma](https://onco.cc/cancers/paediatric-low-grade-glioma/), [Papillary tumour of the pineal region](https://onco.cc/cancers/papillary-tumour-pineal-region/), [Pineoblastoma](https://onco.cc/cancers/pineoblastoma/), [Pineocytoma and pineal parenchymal tumour of intermediate differentiation](https://onco.cc/cancers/pineal-parenchymal-tumours/), [Pituitary tumours (pituitary neuroendocrine tumours) and pituitary carcinoma](https://onco.cc/cancers/pituitary-tumours/), [Primary CNS lymphoma](https://onco.cc/cancers/primary-cns-lymphoma/), [Spinal cord tumours (intramedullary and intradural)](https://onco.cc/cancers/spinal-cord-tumours/), [Vestibular schwannoma (acoustic neuroma)](https://onco.cc/cancers/vestibular-schwannoma/)
- technologies: [CyberKnife robotic radiosurgery](https://onco.cc/technologies/cyberknife/), [Focused-ultrasound blood-brain barrier opening](https://onco.cc/technologies/bbb-focused-ultrasound/), [Gamma Knife](https://onco.cc/technologies/gamma-knife/), [Intraoperative MRI and CT](https://onco.cc/technologies/intraoperative-mri-ct/), [Laser interstitial thermal therapy systems (NeuroBlate, Visualase)](https://onco.cc/technologies/litt-systems/), [Methylation classifier for brain tumours](https://onco.cc/technologies/cns-tumour-methylation-classifier/), [MRI field strengths: 1.5 T, 3 T and 7 T](https://onco.cc/technologies/mri-field-strengths/), [Pencil-beam scanning and intensity-modulated proton therapy](https://onco.cc/technologies/intensity-modulated-proton-therapy/), [Proliferation-invasion (reaction-diffusion) models of glioma](https://onco.cc/technologies/reaction-diffusion-glioma-model/), [Proton therapy machines: cyclotrons, synchrotrons and single-room systems](https://onco.cc/technologies/proton-therapy-systems/), [Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS)](https://onco.cc/technologies/radiosurgery-srs/), [Transcranial focused ultrasound systems (Exablate Neuro, SonoCloud)](https://onco.cc/technologies/transcranial-focused-ultrasound-systems/), [ZAP-X gyroscopic radiosurgery](https://onco.cc/technologies/zap-x/)
- targets: [BRAF](https://onco.cc/targets/braf/), [CDKN2C](https://onco.cc/targets/cdkn2c/), [DICER1](https://onco.cc/targets/dicer1/), [DROSHA](https://onco.cc/targets/drosha/), [IDH1 / IDH2](https://onco.cc/targets/idh/), [MEK1/2](https://onco.cc/targets/mek/), [MUTYH](https://onco.cc/targets/mutyh/), [RAD51D](https://onco.cc/targets/rad51d/)
- drugs: [Dabrafenib](https://onco.cc/drugs/dabrafenib/), [Dordaviprone](https://onco.cc/drugs/dordaviprone/), [Emavusertib](https://onco.cc/drugs/emavusertib/), [Temozolomide](https://onco.cc/drugs/temozolomide/), [Tovorafenib](https://onco.cc/drugs/tovorafenib/), [Trametinib](https://onco.cc/drugs/trametinib/), [Vorasidenib](https://onco.cc/drugs/vorasidenib/)
- trials: [A Phase 1-2 Study of ST101 in Patients With Advanced Solid Tumors](https://onco.cc/trials/nct04478279/), [A Pivotal Phase II Clinical Trial of Utidelone Injection Plus Capecitabine in HER2-negative Breast Cancer Patients With Brain Metastases](https://onco.cc/trials/nct06764940/), [A Prospective Pivotal Study to Evaluate the Efficacy and Safety of Avastin® Bevacizumab (BEV) With or Without Microbubble-mediated Focused Ultrasound (FUS-MB) Using NaviFUS System in Recurrent Glioblastoma Multiforme Patients](https://onco.cc/trials/nct06496971/), [A Study Evaluating the Safety, Pharmacokinetics, and Efficacy of Alectinib in Pediatric Participants With ALK Fusion-Positive Solid or CNS Tumors](https://onco.cc/trials/nct04774718/), [A Study of Repotrectinib in Pediatric and Young Adult Subjects Harboring ALK, ROS1, OR NTRK1-3 Alterations](https://onco.cc/trials/nct04094610/), [A Study to Evaluate Tabelecleucel in Participants With Epstein Barr Virus (EBV) Associated Diseases](https://onco.cc/trials/nct04554914/), [ACNS0121](https://onco.cc/trials/acns0121/), [ACNS0122](https://onco.cc/trials/acns0122/), [ACNS0333](https://onco.cc/trials/acns0333/), [ACNS1123](https://onco.cc/trials/acns1123/), [ACNS1422](https://onco.cc/trials/acns1422/), [Alliance N0574 (NCCTG N0574)](https://onco.cc/trials/alliance-n0574/), [Antineoplaston Therapy in Treating Patients With Primary Malignant Brain Tumors](https://onco.cc/trials/nct00003475/), [AVAglio](https://onco.cc/trials/avaglio/), [Blood Brain Barrier (BBB) Disruption Using Exablate Focused Ultrasound With Doxorubicin for Treatment of Pediatric Diffuse Intrinsic Pontine Gliomas (DIPG)](https://onco.cc/trials/nct05630209/), [Blood Brain Barrier (BBB) Disruption Using Exablate Focused Ultrasound With Doxorubicin for Treatment of Pediatric DIPG](https://onco.cc/trials/nct05615623/), [CA-4948-101: Open-Label, Dose Escalation and Expansion Trial of Emavusertib (CA-4948) in Relapsed or Refractory Primary Central Nervous System Lymphoma (R/R PCNSL)](https://onco.cc/trials/nct03328078/), [CATNON (EORTC 26053-22054)](https://onco.cc/trials/catnon/), [Efficacy and Safety of SPH4336 in Combination With Endocrine Therapy in Breast Cancer Patients With Brain Metastases.](https://onco.cc/trials/nct05872347/), [EORTC 22033-26033](https://onco.cc/trials/eortc-22033/), [EORTC 26951](https://onco.cc/trials/eortc-26951/), [GBM AGILE](https://onco.cc/trials/gbm-agile/), [IELSG32](https://onco.cc/trials/ielsg32/), [INTELLANCE-1](https://onco.cc/trials/intellance-1/), [INTUITT-NF2](https://onco.cc/trials/intuitt-nf2/), [MATRix/IELSG43](https://onco.cc/trials/ielsg43/), [NOA-08](https://onco.cc/trials/noa-08/), [NRG CC001](https://onco.cc/trials/nrg-cc001/), [Phase 2b Imaging Study of RAD101 in Participants With Suspected Recurrent Brain Metastases](https://onco.cc/trials/nct06777433/), [Post-Surgical Stereotactic Radiotherapy (SRT) Versus GammaTile-ROADS (Radiation One and Done Study)](https://onco.cc/trials/nct04365374/), [QUARTZ](https://onco.cc/trials/quartz/), [RTOG 9402](https://onco.cc/trials/rtog-9402/), [SJMB12](https://onco.cc/trials/sjmb12/), [Study of a Drug [DCVax®-L] to Treat Newly Diagnosed GBM Brain Cancer](https://onco.cc/trials/nct00045968/), [Study of Abemaciclib and Elacestrant in Participants With Brain Metastasis Due to ER+/HER-2- Breast Cancer](https://onco.cc/trials/nct05386108/), [Study Of Entrectinib (Rxdx-101) in Children and Adolescents With Locally Advanced Or Metastatic Solid Or Primary CNS Tumors And/Or Who Have No Satisfactory Treatment Options](https://onco.cc/trials/nct02650401/), [Study of ICP-723 in Patients With Advanced Solid Tumors or Primary Central Nervous System Tumors](https://onco.cc/trials/nct05745623/), [Study of Silevertinib With Temozolomide for the Treatment of Newly Diagnosed GBM With Unmethylated MGMT and EGFRvIII](https://onco.cc/trials/nct07326566/), [Surgery, Radiation Therapy, and Chemotherapy With or Without Photodynamic Therapy in Treating Patients With Newly Diagnosed or Recurrent Malignant Supratentorial Gliomas](https://onco.cc/trials/nct00003788/), [TY-9591 in the Patients With EGFR Mutations in Advanced NSCLC With Brain Metastases](https://onco.cc/trials/nct05948813/)
- people: [Andrew B. Lassman](https://onco.cc/people/andrew-lassman/), [Jan C. Buckner](https://onco.cc/people/jan-buckner/), [Olivier L. Chinot](https://onco.cc/people/olivier-chinot/), [Paul D. Brown](https://onco.cc/people/paul-brown/), [Scott R. Plotkin](https://onco.cc/people/scott-plotkin/)
- companies: [Blaze Bioscience](https://onco.cc/companies/blaze-bioscience/), [Radiopharm Theranostics](https://onco.cc/companies/radiopharm-theranostics/), [TYK Medicines](https://onco.cc/companies/tyk-medicines/)
- terms: [Radiation necrosis (brain)](https://onco.cc/terms/radiation-necrosis/)

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JSON: https://onco.cc/api/v1/entities/brain-tumours.json