Brain tumours are an aggressive and rapidly progressing class of cancers,
whose complexity limits effective treatment options. This chapter examines the
complexities and hurdles associated with employing pharmacological modulations as a
therapeutic approach. Pharmacological modulations are an emerging requirement in
tumour management, which calls for improved and innovative strategies.
Pharmacological modulations promise to alter the biological environment of tumors,
sensitizing, potentiating, and overcoming drug resistance. Sensitisation to increase
tumour vulnerability to drugs, potentiation to increase drug efficacy, and overcoming
resistance by targeting pathways that stem the tumour proliferation are the main
approaches in pharmacological modulation. Targeted therapies, like tyrosine kinase
inhibitors, also play a crucial role. This chapter provides a concise overview of primary
and metastatic tumors, highlighting the molecular and cellular interactions that
influence drug response and the hindrance posed by the heterogeneous barrier, the
blood-brain barrier (BBB). Various therapeutic approaches have been discussed,
including small-molecule inhibitors, monoclonal antibodies, and innovative ones such
as RNA-targeting therapies and nano-oncology. Case studies have been cited to prove
that modulation strategies successfully overcome biological hurdles. Prevailing
challenges, which almost seem unbeatable, such as the BBB, are discussed in detail,
along with approaches to overcome them and enhance drug delivery, including
nanoparticle formulations and combination therapies. Pharmacological modulations
proved promising results in treating brain tumours despite challenges like the BBB.
Continued research and the development of innovative approaches are essential for
further progress in brain tumor treatment. Personalized therapies and improved drug
delivery systems offer hope for more effective treatment options in the future.
Keywords: Blood-brain barrier (BBB), Brain tumour, Biomarkers, Monoclonal antibodies and antibody-drug conjugates, Nano-oncology, Pharmacological modulation, PD-1/PD-L1 pathways, RNA-targeting therapies, Tyrosine kinase inhibitors.
