title: Principles of pharmacotherapy.
abstract: This chapter will review the challenges in pharmacotherapy in primary brain tumors that include the presence of the blood-brain barrier, a blood-tumor barrier, active drug efflux pumps, and high plasma protein binding of agents. The approaches to improve the delivery of drugs to the brain will be discussed. Often the management of brain tumors involves the use of corticosteroids and enzyme-inducing antiseizure medications that can have significant drug interactions that may impact the efficacy or toxicity of drugs used to treat these patients. Various techniques used to assess drug distribution to the brain will be reviewed.
authors.affiliation: Department of Neurology, Harvard Medical School and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston, MA, USA. Electronic address: tbatchelor@mgh.harvard.edu.
authors.forename: Tracy
authors.initials: T
authors.lastname: Batchelor
authors.affiliation: Vall D'Hebron Institute of Oncology and Universitat Autonoma de Barcelona, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Rodon
authors.affiliation: Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Manmeet
authors.initials: M
authors.lastname: Ahluwalia
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001812:Blood-Brain Barrier / Q000502:physiology; D001932:Brain Neoplasms / Q000188:drug therapy*; D016503:Drug Delivery Systems; D005910:Glioma / Q000188:drug therapy*; D006801:Humans
chemical_list: D000970:Antineoplastic Agents
keywords: blood–brain barrier; chemotherapy; convection-enhanced delivery; drug delivery; intrathecal; pharmacotherapy