Brain and spinal cord tumours: the decisions you may face

Cancer page →Second-opinion finder →

3 treatment settings, 1 with more than one named option. Each section lays out the options the standard of care names, what each is for, the trials behind them with their recorded results, the side effects and cautions on record, and questions to ask. Built from the cancer page's standard-of-care rows; nothing here is advice for your case.

Other settings

Glioblastoma

One path named

Maximal safe resection, radiotherapy with concurrent and adjuvant temozolomide (Stupp regimen), tumour-treating fields as an option. See the glioblastoma page.

The path, in plain words

TemozolomideStandard of careOral alkylating chemotherapy

The only chemotherapy proven to extend life in glioblastoma, given during and after radiation. It works best when the tumour has switched off a repair gene called MGMT.

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

Temozolomide all recorded rates →

Take on an empty stomach or at bedtime to reduce nausea; PJP prophylaxis during concurrent chemoradiation.

Questions to ask about this decision

Is Temozolomide the only reasonable path for me, or is there a trial, a different sequence or a wait-and-see option?
Why: A single standard does not mean a single choice; timing and trials are decisions too.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (glioblastoma), which of the standard options do you recommend and why?
Why: Guideline options include: Maximal safe resection, radiotherapy with concurrent and adjuvant temozolomide (Stupp regimen), tumour-treating fields as an option. See the glioblastoma page.
Am I a candidate for Temozolomide, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Add these to your appointment list, or take the full question set for this cancer.

Other settings

IDH-mutant low-grade glioma

One path named

Surgery, then observation or vorasidenib for grade 2 tumours, radiotherapy and chemotherapy for higher risk.

The path, in plain words

VorasidenibApprovedSmall-molecule IDH1/2 inhibitor

The first targeted therapy for low-grade brain tumours, delaying the need for radiation and chemotherapy by years.

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

No side-effect rates or interaction flags are recorded for these options yet. The side-effect lookup and interaction checker cover the products that have them.

Questions to ask about this decision

Is Vorasidenib the only reasonable path for me, or is there a trial, a different sequence or a wait-and-see option?
Why: A single standard does not mean a single choice; timing and trials are decisions too.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (idh-mutant low-grade glioma), which of the standard options do you recommend and why?
Why: Guideline options include: Surgery, then observation or vorasidenib for grade 2 tumours, radiotherapy and chemotherapy for higher risk.
Am I a candidate for Vorasidenib, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Add these to your appointment list, or take the full question set for this cancer.

Other settings

Childhood tumours

2 optionsCompare side by side →

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.

The options, in plain words

DabrafenibApprovedSmall-molecule BRAF kinase inhibitor

Dabrafenib (Tafinlar) is a capsule that switches off the faulty BRAF protein driving some melanomas, lung, thyroid and other cancers. It is almost always paired with trametinib.

TrametinibApprovedSmall-molecule allosteric MEK1/2 inhibitor

Trametinib (Mekinist) blocks MEK, the protein one step below BRAF in the growth-signal chain. Paired with dabrafenib it treats BRAF-mutant melanoma, lung, thyroid and other cancers, including brain tumours in children.

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

No side-effect rates or interaction flags are recorded for these options yet. The side-effect lookup and interaction checker cover the products that have them.

Questions to ask about this decision

Between Dabrafenib and Trametinib, which do you recommend for me, and what about my case would make you choose differently?
Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (childhood tumours), which of the standard options do you recommend and why?
Why: Guideline options include: 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.
Am I a candidate for Dabrafenib, Trametinib, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Add these to your appointment list, or take the full question set for this cancer.

How to read this page. Options and results come from OnCo records with their sources; the settings are the standard-of-care rows on the cancer page, and the lines of therapy are on the sequencing grid. Where a setting names one path, the choice is usually about timing, trials and where to be treated: see expert centres. OnCo is orientation, not medical advice.

Living with cancer·Standard of care

Brain and spinal cord tumours: the decisions you may face

Cancer page →Second-opinion finder →

Other settings

Glioblastoma

One path named

Maximal safe resection, radiotherapy with concurrent and adjuvant temozolomide (Stupp regimen), tumour-treating fields as an option. See the glioblastoma page.

The path, in plain words

TemozolomideStandard of careOral alkylating chemotherapy

The only chemotherapy proven to extend life in glioblastoma, given during and after radiation. It works best when the tumour has switched off a repair gene called MGMT.

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

Temozolomide all recorded rates →

Take on an empty stomach or at bedtime to reduce nausea; PJP prophylaxis during concurrent chemoradiation.

Questions to ask about this decision

Is Temozolomide the only reasonable path for me, or is there a trial, a different sequence or a wait-and-see option?
Why: A single standard does not mean a single choice; timing and trials are decisions too.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (glioblastoma), which of the standard options do you recommend and why?
Why: Guideline options include: Maximal safe resection, radiotherapy with concurrent and adjuvant temozolomide (Stupp regimen), tumour-treating fields as an option. See the glioblastoma page.
Am I a candidate for Temozolomide, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Add these to your appointment list, or take the full question set for this cancer.

Other settings

IDH-mutant low-grade glioma

One path named

Surgery, then observation or vorasidenib for grade 2 tumours, radiotherapy and chemotherapy for higher risk.

The path, in plain words

VorasidenibApprovedSmall-molecule IDH1/2 inhibitor

The first targeted therapy for low-grade brain tumours, delaying the need for radiation and chemotherapy by years.

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

No side-effect rates or interaction flags are recorded for these options yet. The side-effect lookup and interaction checker cover the products that have them.

Questions to ask about this decision

Is Vorasidenib the only reasonable path for me, or is there a trial, a different sequence or a wait-and-see option?
Why: A single standard does not mean a single choice; timing and trials are decisions too.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (idh-mutant low-grade glioma), which of the standard options do you recommend and why?
Why: Guideline options include: Surgery, then observation or vorasidenib for grade 2 tumours, radiotherapy and chemotherapy for higher risk.
Am I a candidate for Vorasidenib, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Add these to your appointment list, or take the full question set for this cancer.

Other settings

Childhood tumours

2 optionsCompare side by side →

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.

The options, in plain words

DabrafenibApprovedSmall-molecule BRAF kinase inhibitor

Dabrafenib (Tafinlar) is a capsule that switches off the faulty BRAF protein driving some melanomas, lung, thyroid and other cancers. It is almost always paired with trametinib.

TrametinibApprovedSmall-molecule allosteric MEK1/2 inhibitor

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

No side-effect rates or interaction flags are recorded for these options yet. The side-effect lookup and interaction checker cover the products that have them.

Questions to ask about this decision

Between Dabrafenib and Trametinib, which do you recommend for me, and what about my case would make you choose differently?
Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (childhood tumours), which of the standard options do you recommend and why?
Why: Guideline options include: 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.
Am I a candidate for Dabrafenib, Trametinib, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Add these to your appointment list, or take the full question set for this cancer.