Medication for Skull Base Tumors

Depending on the specific type of skull base tumor, NYU Langone doctors may prescribe chemotherapy, a group of drugs used to destroy cancer cells throughout the body, as part of a comprehensive treatment plan. Some malignant skull base tumors that may respond to chemotherapy include nasopharyngeal carcinomas, which are squamous cell cancers; adenoid cystic carcinomas; or esthesioneuroblastomas.

Chemotherapy may be given at the same time as radiation therapy. This may prevent some skull base tumors, such as nasopharyngeal carcinomas, from returning after surgery. The timing for radiation therapy and chemotherapy is determined by your medical and radiation oncologists and depends on the type and location of the tumor.

Chemotherapy may be used alone if the cancer spreads to other parts of the body.

Most chemotherapy drugs used to treat skull base tumors are given through a vein with intravenous (IV) infusion. Usually, doctors prescribe a combination of drugs. Treatment may be given for several hours at a time, a few days a week, every three or four weeks. This is considered a single cycle, and your doctor may prescribe several cycles. Doctors can work with you to determine the best schedule for you based on the tumor type and how advanced it is.

For some types of skull base tumors, doctors may prescribe targeted drugs, which destroy cancerous cells while avoiding healthy tissue. For example, doctors may use cetuximab—a monoclonal antibody composed of immune system proteins that destroy proteins on cancerous cells—to manage nasopharyngeal carcinoma.

Cetuximab targets the epidermal growth factor receptor protein that sits on the surface of nasopharyngeal tumors. This protein “tells” cancer cells to grow and divide. Epidermal growth factor receptor inhibitors block this process, slowing tumor growth.

Doctors may also prescribe a variety of medications to manage pituitary tumors. As one example, dopamine agonists may be used to manage tumors that produce excessive amounts of the hormone prolactin, which stimulates the production of breast milk. Dopamine agonists can prevent these tumors from making too much prolactin, causing them to shrink. Most often this type of pituitary tumor is treated with medications, rather than surgery.

Common side effects of chemotherapy include fatigue, nausea, vomiting, diarrhea, and hair loss. Cetuximab is associated with a rash and itching. Dopamine agonists may cause nausea and vomiting.

You may be able to avoid these side effects by taking a different dose of the medication, trying another drug, or using our many integrative health services. Our doctors monitor your medications throughout treatment and can adjust doses or types of medications as necessary.