Neurinoma, also known as vestibular schwannoma, is a noncancerous tumor that develops on the sheath covering the vestibular nerve. This nerve connects the inner ear to the brain and plays a vital role in maintaining balance and hearing. A neurinoma, or vestibular schwannoma, is a benign tumor that arises from Schwann cells. These cells are responsible for producing the protective covering (myelin sheath) around nerves. In the case of a neurinoma, the tumor develops on the eighth cranial nerve, specifically the vestibular branch. This nerve is crucial for maintaining balance and transmitting sound information from the inner ear to the brain.
The exact cause of neurinomas is not fully understood. However, researchers believe that a mutation in the NF2 gene is often responsible for the development of these tumors. The NF2 gene normally acts as a tumor suppressor, preventing the growth of abnormal cells. When this gene is mutated, it fails to control cell growth, leading to the formation of vestibular schwannomas.
Types
Types of Neurinoma:
- Vestibular Schwannoma: Vestibular schwannomas are the most common type of neurinoma, accounting for approximately 90% of cases. They develop from Schwann cells that cover the vestibular branch of the eighth cranial nerve, which is responsible for balance and hearing. These tumors usually grow slowly and may cause symptoms such as gradual hearing loss, tinnitus (ringing in the ears), dizziness, and balance problems.
- Facial Nerve Neurinoma: Facial nerve neurinomas, also known as facial schwannomas, originate from the Schwann cells surrounding the facial nerve. Although relatively rare, these tumors can affect the facial nerve’s functions, leading to facial weakness or paralysis on the affected side. Other symptoms may include facial twitching, numbness, or pain.
- Trigeminal Schwannoma: Trigeminal schwannomas arise from the Schwann cells enveloping the trigeminal nerve, which is responsible for sensation in the face. These tumors are relatively uncommon and often present with symptoms such as facial pain, tingling, or numbness in the affected area. In some cases, they may cause compression of nearby structures, leading to problems with chewing or speaking.
- Other Rare Neurinoma Types: While less common, there are other rare types of neurinomas that can develop in different locations. These include schwannomas affecting the spinal nerves (spinal schwannomas), optic nerve (optic nerve schwannomas), and peripheral nerves (peripheral schwannomas). Each of these tumors presents with unique symptoms related to the affected nerve or region.
Causes
While the exact cause of neurinoma is unknown, there are several factors that may contribute to its development.
- Genetic Predisposition: Certain genetic conditions, such as Neurofibromatosis type 2 (NF2), can significantly increase the risk of developing neurinoma. Individuals with NF2 have a faulty gene that increases the likelihood of tumor growth on the nerves.
- Environmental Factors: Exposure to certain environmental factors, including ionizing radiation, has been associated with an increased risk of developing neurinoma. Occupational exposure to radiation or previous radiation therapy may contribute to tumor formation.
- Age: The risk of neurinoma tends to increase with age, particularly in individuals between the ages of 30 and 60. However, it can occur at any age, including childhood.
- Gender: Females have a slightly higher risk of developing neurinoma compared to males. The reason for this gender disparity is not yet fully understood.
- Hormonal Imbalance: Hormonal changes, such as those occurring during pregnancy or menopause, may influence the development or growth of neurinoma. However, further research is needed to establish a clear link.
- Neurofibromatosis Type 1 (NF1): NF1, another genetic condition, can also increase the risk of developing neurinoma. This condition causes tumors to form along the nerves, including the vestibular nerve.
- Acoustic Neuroma Type 2 (AN2): AN2 is a rare genetic condition characterized by the development of multiple vestibular schwannomas, greatly elevating the risk of neurinoma.
- Previous Head or Ear Trauma: Head or ear trauma, such as a severe blow to the head or chronic ear infections, has been proposed as a potential cause for neurinoma. However, the relationship between trauma and tumor formation requires further investigation.
- Viral Infections: Certain viral infections, such as the human cytomegalovirus (CMV) or herpes simplex virus (HSV), have been suggested as potential triggers for neurinoma. Research is ongoing to determine the precise mechanisms involved.
- Immune System Dysfunction: An impaired immune system might be associated with an increased risk of neurinoma. Autoimmune disorders or other immune system dysfunctions may contribute to the development of tumors.
- Hormone Replacement Therapy (HRT): Long-term use of hormone replacement therapy, particularly estrogen-progestin combinations, has been implicated as a potential risk factor for neurinoma. However, more research is needed to establish a definitive link.
- Chemical Exposure: Exposure to certain chemicals, such as vinyl chloride, a substance used in the production of plastics, has been associated with an increased risk of developing neurinoma. Occupational exposure to these chemicals should be minimized.
- High Blood Pressure (Hypertension): There is some evidence to suggest that individuals with high blood pressure may have an elevated risk of neurinoma. Maintaining healthy blood pressure levels through lifestyle modifications may be beneficial.
- Diabetes: While the exact relationship is not fully understood, some studies have found a possible association between diabetes and an increased risk of developing neurinoma. Further research is necessary to establish a conclusive link.
- Obesity: Obesity has been suggested as a potential risk factor for neurinoma. Adopting a healthy lifestyle and maintaining a healthy weight may help reduce the risk.
- Smoking: Smoking is a well-known risk factor for various types of cancer. While the direct link between smoking and neurinoma is not yet established, quitting smoking is highly recommended for overall health and well-being.
- Alcohol Consumption: Excessive alcohol consumption has been associated with an increased risk of developing various types of tumors, including neurinoma. Moderation in alcohol consumption is advised.
- Hormonal Contraceptives: The use of hormonal contraceptives, such as birth control pills, has been suggested as a potential risk factor for neurinoma. However, the association remains controversial, and further research is needed to confirm these findings.
- Chronic Inflammation: Persistent inflammation in the body may contribute to tumor development. Conditions associated with chronic inflammation, such as chronic infections or inflammatory diseases, could potentially increase the risk of neurinoma.
- Poor Diet: An unhealthy diet lacking in essential nutrients, particularly antioxidants, may contribute to the development of tumors. A balanced diet rich in fruits, vegetables, and whole grains is recommended.
- Occupational Hazards: Certain occupations, such as workers in the telecommunications or electrical industries, may be exposed to electromagnetic fields, which have been suggested as a potential risk factor for neurinoma. Safety precautions should be followed in such work environments.
- Hormonal Imbalance: Conditions characterized by hormonal imbalances, such as polycystic ovary syndrome (PCOS) or thyroid disorders, may increase the risk of neurinoma. Proper management of these conditions is important.
- Chronic Stress: Prolonged exposure to high levels of stress may negatively impact the immune system and increase the risk of tumor development. Stress management techniques should be implemented to reduce this risk.
- Excessive Sun Exposure: While the association between excessive sun exposure and neurinoma is not well-established, it is advisable to protect oneself from harmful UV radiation to minimize the risk of various health issues.
- Medications: Certain medications, such as some types of antiviral drugs or medications used to suppress the immune system, have been suggested as potential risk factors for neurinoma. Consultation with a healthcare professional is essential when taking such medications.
- Hormonal Imbalance: Hormonal changes during the menstrual cycle or due to hormone-secreting tumors may potentially contribute to the development of neurinoma. Hormonal imbalances should be evaluated and managed appropriately.
- Family History: Having a first-degree relative, such as a parent or sibling, with a history of neurinoma increases the risk of developing the condition. Genetic counseling and regular screenings may be recommended in such cases.
- Hormonal Disorders: Certain hormonal disorders, such as acromegaly or Cushing’s syndrome, may increase the risk of neurinoma. Proper management of these conditions is crucial.
- Reduced Immune Function: A weakened immune system, such as that seen in individuals with HIV/AIDS or those undergoing organ transplantation, may increase the susceptibility to neurinoma. Regular medical care and immune system support are important.
- Unknown Factors: Despite extensive research, there are cases where the cause of neurinoma remains unknown. Ongoing scientific investigations aim to uncover additional factors contributing to the development of this condition.
Symptoms
Symptoms are crucial for early diagnosis and timely treatment
- Numbness or Tingling Sensations: Neurinomas can cause numbness or tingling sensations in the affected area. This symptom is often described as a feeling of “pins and needles” or a loss of sensation.
- Muscle Weakness: Weakness in the muscles connected to the affected nerve may occur due to the compression caused by the neurinoma. This weakness can manifest as difficulty in gripping objects or performing routine activities.
- Pain or Discomfort: Persistent pain or discomfort in the area near the affected nerve is a common symptom of neurinoma. The pain may vary in intensity and can be described as sharp, shooting, or dull.
- Swelling or Lump: Neurinomas can lead to the formation of a noticeable lump or swelling. This swelling is typically painless and can be observed or felt beneath the skin.
- Loss of Coordination: Impaired coordination can occur when the neurinoma affects nerves responsible for motor control. This may manifest as clumsiness or difficulty with precise movements.
- Balance Problems: Neurinomas near nerves involved in balance can cause issues with equilibrium. Affected individuals may experience dizziness, a sensation of being off-balance, or problems with coordination during activities like walking.
- Hearing Changes: Neurinomas that develop on the auditory nerve can result in hearing changes. This may include hearing loss, ringing in the ears (tinnitus), or a feeling of fullness in the affected ear.
- Vision Problems: In some cases, neurinomas near the optic nerve can cause vision problems. These problems may include blurred vision, double vision (diplopia), or a loss of peripheral vision.
- Facial Weakness: When the facial nerve is affected by a neurinoma, it can lead to facial weakness. This can cause difficulties with facial expressions, smiling, closing the eye on the affected side, or other facial movements.
- Speech and Swallowing Difficulties: Neurinomas located near the nerves responsible for speech and swallowing can result in difficulties in these functions. Individuals may experience slurred speech, hoarseness, or trouble swallowing.
- Headaches: Frequent or severe headaches can be a symptom of a neurinoma, especially if the tumor is located in the head or neck region. These headaches may be accompanied by other neurological symptoms.
- Back or Neck Pain: Neurinomas that develop along the spinal nerves can cause localized back or neck pain. This pain may radiate down the arms or legs, depending on the location of the tumor.
- Changes in Sensation: Altered sensations such as a loss of feeling, hypersensitivity, or unusual sensations like burning or itching may occur in the area innervated by the affected nerve.
- Muscle Wasting: In advanced cases, neurinomas can lead to muscle wasting or atrophy. This occurs when the tumor compresses the nerve for an extended period, causing the affected muscles to weaken and shrink.
- Frequent Urination: Neurinomas that affect nerves related to bladder control can lead to an increased frequency of urination. This symptom may be accompanied by urgency or difficulty fully emptying the bladder.
- Bowel Dysfunction: Neurinomas near nerves involved in bowel control can result in bowel dysfunction. This can include constipation, diarrhea, or a loss of bowel control.
- Fatigue and Weakness: General fatigue and weakness may occur as a result of the constant strain on the affected nerve and the associated pain or discomfort.
- Temperature Sensitivity: Some individuals with neurinomas may experience sensitivity to temperature changes. They may have heightened sensitivity to cold or heat in the affected area.
- Sleep Disturbances: The presence of neurinomas can lead to sleep disturbances due to pain, discomfort, or associated symptoms. This may result in difficulty falling asleep or staying asleep throughout the night.
- Psychological Effects: Living with the symptoms of a neurinoma can have psychological effects such as anxiety, depression, or frustration. These emotional responses are natural considering the impact on daily life and well-being.
Diagnosis
Diagnostic methods and tests are commonly used to identify and evaluate neurinomas.
- Clinical History and Physical Examination: A comprehensive clinical history, along with a thorough physical examination, is the first step in diagnosing a neurinoma. The healthcare professional will inquire about symptoms such as hearing loss, tinnitus, and balance problems, while also assessing facial nerve function.
- Audiometry: Audiometry measures hearing thresholds, helping to identify any hearing loss associated with neurinomas. It involves presenting sounds of varying frequencies and intensities to the patient, who then indicates when they can hear them.
- Speech Audiometry: Speech audiometry evaluates the patient’s ability to understand speech at different volumes. This test helps determine the extent of hearing loss caused by the neurinoma.
- Pure-tone Audiometry: Pure-tone audiometry determines the quietest sounds a patient can hear at different frequencies, assisting in the identification and characterization of hearing loss caused by neurinomas.
- Tympanometry: Tympanometry assesses the movement of the eardrum in response to changes in air pressure, providing valuable information about middle ear function and potential nerve involvement.
- Acoustic Reflex Testing: Acoustic reflex testing measures the involuntary contraction of the stapedius muscle in response to loud sounds. Abnormal reflexes may indicate the presence of a neurinoma.
- Otoacoustic Emissions (OAE): OAE testing evaluates the sounds produced by the inner ear in response to stimuli. Absent or abnormal emissions can suggest damage to the inner ear caused by a neurinoma.
- Magnetic Resonance Imaging (MRI): MRI is the gold standard imaging technique for diagnosing neurinomas. It provides detailed images of the brain and surrounding structures, enabling the identification, localization, and characterization of the tumor.
- Computed Tomography (CT) Scan: CT scans use X-rays to create detailed cross-sectional images of the brain. They are particularly useful in evaluating bony changes and identifying larger neurinomas.
- High-Resolution Contrast-Enhanced MRI: This specialized MRI technique employs a contrast agent to enhance the visualization and characterization of neurinomas. It helps to differentiate between various types of tumors and aids in treatment planning.
- Diffusion-Weighted Imaging (DWI): DWI measures the movement of water molecules within tissues, assisting in the differentiation between neurinomas and other brain tumors based on their cellular characteristics.
- Magnetic Resonance Angiography (MRA): MRA is a non-invasive imaging technique that assesses blood vessels in the brain. It can help determine the blood supply to the tumor, aiding in surgical planning.
- CT Angiography (CTA): CTA combines CT scanning with the injection of a contrast agent to visualize blood vessels. It is particularly useful for identifying large tumors and assessing blood flow.
- Electrocochleography (ECOG): ECOG measures the electrical responses generated by the cochlea and auditory nerve. It helps assess hearing loss and identify abnormalities associated with neurinomas.
- Brainstem Auditory Evoked Response (BAER) Test: BAER measures the brain’s electrical activity in response to sound stimulation. It can help evaluate the integrity of the auditory pathway, assisting in the diagnosis of neurinomas.
- Posturography: Posturography evaluates a patient’s balance and postural control. It can help identify balance disturbances caused by vestibular schwannomas.
- Video Head Impulse Test (vHIT): vHIT assesses the vestibular-ocular reflex, which controls eye movements during head rotation. It aids in detecting vestibular dysfunction caused by neurinomas.
- Electronystagmography (ENG): ENG measures eye movements to assess vestibular function. It can help determine whether a neurinoma is affecting the vestibular system.
- Caloric Testing: Caloric testing involves irrigating the ear canal with warm or cool water to evaluate the vestibular system’s response. It helps identify any abnormalities caused by a neurinoma.
- Cerebrospinal Fluid (CSF) Analysis: CSF analysis examines the fluid surrounding the brain and spinal cord for abnormal cell counts, protein levels, and other markers. It can provide additional information in cases where a neurinoma is suspected.
- Genetic Testing: Genetic testing may be performed to detect mutations associated with certain hereditary forms of neurinomas. It helps determine the risk of developing tumors in other family members.
- Immunohistochemistry: Immunohistochemistry involves staining tumor tissue samples with specific antibodies to identify molecular markers associated with neurinomas. It aids in confirming the diagnosis and determining appropriate treatment options.
- Biopsy: A biopsy involves the surgical removal of a small sample of tumor tissue for microscopic examination. While rare, a biopsy may be performed in cases where the diagnosis remains uncertain or for research purposes.
- Genetic Counseling: Genetic counseling provides individuals and families with information about the genetic risks and implications associated with neurinomas. It helps guide decision-making and provides support throughout the diagnostic and treatment process.
- Serial Monitoring: Serial monitoring involves regular follow-up imaging and tests to track tumor growth and assess treatment efficacy. It is essential in cases where the tumor is small or asymptomatic.
- Preoperative Embolization: Preoperative embolization is a procedure where a catheter is used to inject materials into the blood vessels feeding the tumor. It helps reduce blood flow to the tumor, making surgical removal safer.
- Facial Nerve Monitoring: During surgery, facial nerve monitoring is employed to assess the function of the facial nerve in real time. It helps minimize the risk of nerve damage during tumor removal.
- Postoperative Imaging: Postoperative imaging, such as MRI or CT scans, is conducted after surgical removal of the tumor to ensure complete resection and monitor for any residual or recurrent tumor.
- Hearing Tests and Rehabilitation: Following tumor removal, comprehensive hearing tests and rehabilitation programs may be necessary to address any residual hearing loss and improve overall auditory function.
- Long-term Follow-up: Long-term follow-up is crucial to monitor for any recurrence of the tumor or complications. Regular imaging and clinical evaluations are performed to ensure early detection and timely intervention if required.
Treatment
Effective treatments for neurinoma can aid in your recovery journey.
- Microsurgery: Microsurgery is a commonly employed treatment for neurinoma, involving the use of high-powered microscopes to remove the tumor with precision. The surgeon carefully dissects the tumor, minimizing damage to surrounding tissues and nerves.
- Radiosurgery: Radiosurgery employs focused radiation beams to target and destroy the tumor cells. It is a non-invasive procedure that allows for precise tumor eradication while preserving healthy tissues.
- Gamma Knife Radiosurgery: Gamma Knife Radiosurgery is a specialized form of radiosurgery that uses multiple beams of gamma radiation to deliver highly precise and concentrated doses to the tumor. This treatment minimizes the risk of damaging adjacent structures.
- CyberKnife Radiosurgery: Similar to Gamma Knife Radiosurgery, CyberKnife utilizes advanced robotics to deliver highly accurate radiation doses to the tumor. This treatment offers a non-invasive alternative to traditional surgery.
- Fractionated Stereotactic Radiotherapy: Fractionated stereotactic radiotherapy involves delivering the radiation dose in smaller fractions over multiple treatment sessions. This approach enhances tumor control while reducing the risk of side effects.
- Watchful Waiting: In cases where the tumor is small and not causing significant symptoms, a watchful waiting approach may be adopted. Regular monitoring of the tumor’s growth is performed, and treatment is initiated if necessary.
- Vestibular Rehabilitation Therapy: Vestibular rehabilitation therapy helps individuals manage the symptoms associated with neurinomas, such as balance issues and dizziness. Customized exercise programs are designed to improve balance and promote adaptation.
- Hearing Aid: If hearing loss occurs due to the tumor’s location, hearing aids can be used to amplify sound and improve auditory perception, enhancing the quality of life for individuals with neurinoma.
- Cochlear Implant: For severe or complete hearing loss, a cochlear implant may be recommended. This device bypasses damaged parts of the inner ear and directly stimulates the auditory nerve, providing sound perception.
- Translabyrinthine Surgery: Translabyrinthine surgery involves removing the tumor through an incision behind the ear. This approach provides direct access to the tumor while minimizing the risk of injury to the facial nerve.
- Middle Fossa Surgery: Middle Fossa surgery involves accessing the tumor through an opening above the ear. It is particularly suitable for smaller tumors located in the internal auditory canal.
- Retrosigmoid Surgery: Retrosigmoid surgery entails removing the tumor through an incision made behind the ear, near the back of the skull. This approach provides excellent exposure to the tumor and preserves hearing in some cases.
- Endoscopic-Assisted Microsurgery: Endoscopic-assisted microsurgery combines the use of endoscopes and microsurgical techniques to remove the tumor. This approach allows for enhanced visualization and precision during the procedure.
- Stereotactic Radiosurgery Boost: In cases where surgical removal is not feasible or desired, stereotactic radiosurgery can be used as a boost after partial tumor resection. It delivers focused radiation to the remaining tumor cells.
- Facial Nerve Rehabilitation: Facial nerve rehabilitation involves various therapies and exercises to help restore facial muscle function in individuals who experience facial weakness or paralysis due to neurinoma or its treatment.
- Chemotherapy: Chemotherapy may be used in cases where neurinoma becomes malignant or exhibits aggressive growth patterns. It involves the use of powerful drugs to kill or inhibit the growth of cancerous cells.
- Bevacizumab Therapy: Bevacizumab is a targeted therapy that can be used in combination with other treatments to reduce the size of the tumor. It works by inhibiting the formation of new blood vessels that support tumor growth.
- Gene Therapy: Gene therapy holds promise as a future treatment option for neurinoma. It involves modifying genes to correct abnormalities or enhance the body’s ability to fight the tumor.
- Immunotherapy: Immunotherapy harnesses the body’s immune system to recognize and attack cancer cells. It can be used as a complementary approach alongside other treatments for neurinoma.
- Anti-angiogenic Therapy: Anti-angiogenic therapy targets the tumor’s blood supply, preventing the growth of new blood vessels and restricting its nutrient supply. This approach helps inhibit tumor growth and progression.
- Targeted Drug Therapy: Targeted drug therapy involves the use of medications that specifically target the genetic mutations or proteins driving tumor growth. These drugs can interfere with cancer cell division and survival.
- Hearing Preservation Surgery: In select cases, surgeons prioritize preserving hearing during tumor removal. This specialized surgery aims to minimize damage to the auditory nerve and maximize the chances of maintaining or restoring hearing.
- Facial Nerve-Sparing Surgery: Facial nerve-sparing surgery focuses on preserving the integrity and function of the facial nerve during tumor resection, reducing the risk of facial weakness or paralysis.
- Stereotactic Radiation Therapy: Stereotactic radiation therapy delivers high doses of radiation precisely to the tumor, minimizing exposure to healthy tissues. It can be used as an alternative to surgery or in combination with other treatments.
- Proton Beam Therapy: Proton beam therapy employs protons instead of X-rays to target the tumor. This technique offers better dose distribution and reduces radiation exposure to surrounding tissues.
- Targeted Molecular Therapies: Targeted molecular therapies utilize drugs that specifically target genetic mutations or alterations within tumor cells. These therapies interfere with tumor growth and promote cell death.
- Heat Therapy (Hyperthermia): Hyperthermia involves exposing the tumor to high temperatures, either externally or internally, to damage and destroy cancer cells. It can be used in combination with other treatments for synergistic effects.
- Cryosurgery: Cryosurgery freezes and destroys tumor cells by applying extremely cold temperatures. This technique is often used for smaller tumors and can be performed on an outpatient basis.
- Acupuncture: Acupuncture is a complementary therapy that involves the insertion of thin needles into specific points on the body. It can help alleviate pain, reduce stress, and improve overall well-being during neurinoma treatment.
- Herbal and Nutritional Supplements: Certain herbal and nutritional supplements may offer supportive benefits during neurinoma treatment. Consult with a healthcare professional knowledgeable in oncology to ensure safe and appropriate usage.
Medications
Effective drug treatments for neurinoma, shedding light on their mechanisms of action, benefits, and potential side effects.
- Bevacizumab (Avastin): Bevacizumab is an anti-angiogenic drug that inhibits the formation of new blood vessels, effectively reducing the blood supply to the tumor and impeding its growth. Side effects may include high blood pressure and bleeding.
- Erlotinib (Tarceva): Erlotinib is a targeted therapy drug that blocks the activity of a protein called epidermal growth factor receptor (EGFR), which is often overactive in neurinomas. Common side effects include rash and diarrhea.
- Imatinib (Gleevec): Imatinib is a tyrosine kinase inhibitor that hinders the activity of specific proteins involved in the growth and survival of tumor cells. It may cause nausea, muscle cramps, and fluid retention.
- Everolimus (Afinitor): Everolimus is an mTOR inhibitor that reduces cell proliferation and blood vessel formation. Side effects may include mouth sores, fatigue, and high cholesterol levels.
- Sunitinib (Sutent): Sunitinib is a multi-targeted kinase inhibitor that blocks the growth of blood vessels and inhibits tumor cell proliferation. Potential side effects include fatigue, diarrhea, and skin discoloration.
- Lapatinib (Tykerb): Lapatinib is a dual tyrosine kinase inhibitor that targets the EGFR and HER2 proteins. It may cause hand-foot syndrome, diarrhea, and nausea.
- Temozolomide (Temodar): Temozolomide is an alkylating agent that interferes with DNA replication, leading to cell death. It may result in low blood counts, nausea, and fatigue.
- Trastuzumab (Herceptin): Trastuzumab is a monoclonal antibody that targets the HER2 protein. It is mainly used for neurinomas that overexpress HER2. Side effects may include heart problems and infusion reactions.
- Cetuximab (Erbitux): Cetuximab is an EGFR inhibitor that prevents the growth and spread of tumor cells. Skin rash and infusion reactions are common side effects.
- Vemurafenib (Zelboraf): Vemurafenib is a targeted therapy drug used specifically for neurinomas with a BRAF gene mutation. It may lead to skin changes, fatigue, and joint pain.
- Regorafenib (Stivarga): Regorafenib is a multi-kinase inhibitor that targets several proteins involved in tumor growth. It may cause hand-foot skin reaction, diarrhea, and high blood pressure.
- Osimertinib (Tagrisso): Osimertinib is a targeted therapy drug used for neurinomas with specific EGFR mutations. Side effects may include rash, diarrhea, and lung problems.
- Pazopanib (Votrient): Pazopanib is a multi-kinase inhibitor that hampers the growth of blood vessels and tumor cells. Fatigue, diarrhea, and high blood pressure are potential side effects.
- Lenvatinib (Lenvima): Lenvatinib is a multi-kinase inhibitor that restricts blood vessel formation and tumor growth. Side effects may include fatigue, high blood pressure, and diarrhea.
- Nilotinib (Tasigna): Nilotinib is a tyrosine kinase inhibitor that blocks specific proteins involved in tumor growth. It may lead to low blood counts, nausea, and muscle pain.
- Axitinib (Inlyta): Axitinib is a tyrosine kinase inhibitor that impedes the formation of blood vessels in tumors. Side effects may include high blood pressure, diarrhea, and fatigue.
- Vandetanib (Caprelsa): Vandetanib is a tyrosine kinase inhibitor that targets specific proteins involved in tumor growth. Common side effects include diarrhea, rash, and high blood pressure.
- Temsirolimus (Torisel): Temsirolimus is an mTOR inhibitor that inhibits cell growth and division. It may result in mouth sores, fatigue, and high blood sugar levels.
- Nivolumab (Opdivo): Nivolumab is an immune checkpoint inhibitor that enhances the body’s immune response against tumor cells. Side effects may include fatigue, skin rash, and immune-related adverse events.
- Pembrolizumab (Keytruda): Pembrolizumab is another immune checkpoint inhibitor that stimulates the immune system to fight against tumor cells. Common side effects include fatigue, diarrhea, and skin rash.
References
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