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]

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%)