Chemotherapy and Medical Management of Acoustic Neuromas

An acoustic neuroma (or schwannoma) is a brain tumor found in approximately one out of every 100,000 people that can be challenging to treat. If surgery or radiation therapy fails or is not feasible, your doctor may consider chemotherapy to help control tumor growth. However, the use of chemotherapy for acoustic neuroma is very rare.

If your doctor or medical team does indeed recommend chemotherapy, there is important information you need to know before your chemotherapy or medication therapy begins.

It is not standard practice to use chemotherapy to treat or manage acoustic neuromas. In fact, it is used relatively rarely for this purpose. In some cases, however, such as with patients that have the hereditary form of malignant acoustic neuroma arising from a rare, inherited condition called Neurofibromatosis Type II, doctors may consider chemotherapy if the tumor has not stopped growing. Although several drugs are available to treat acoustic neuromas with varying results, physicians commonly turn to bevacizumab and erlotinib.

This drug was approved in 2004 by the Federal Drug Administration for fighting certain types of cancers and has been placed on the World Health Organization's List of Essential Medicines. It has proved useful in fighting cancer because it slows new blood vessel growth in the tumor.

Bevacizumab is sometimes used as off-label chemotherapy to stabilize the size of acoustic neuromas. Research has found that such off-label use of bevacizumab may result in better long-term hearing outcomes. 

Erlotinib is a reversible, small molecule EGFR-specific tyrosine kinase inhibitor that is commonly used in small-cell lung cancer. It has successfully reduced the growth of schwannoma cells in laboratory mice, decreasing the number of actively dividing tumor cells. However, some studies have shown that when used in acoustic tumors related to Neurofibromatosis Type II, erlotinib was not effective in reducing tumor size or in improving hearing. 

In patients with sporadic acoustic neuromas (non-hereditary), a 2014 study showed erlotinib stabilized or even reduced acoustic neuroma tumors with some patients experiencing hearing improvement over time. More studies are needed to evaluate the effectiveness of this drug before it can be recommended outside of approved clinical trials.

Since the 2000s, initial research suggested that aspirin and other NSAIDS (non-steroidal anti-inflammatory drugs) may assist in stopping or shrinking acoustic neuroma. However, according to subsequent studies, there is no association between taking aspirin and acoustic neuroma tumor growth over time. These medications are not commonly used anymore to treat acoustic neuromas.

At this time, there are no known home or natural remedies to prevent or treat acoustic neuromas. This question is becoming more popular as patients seek holistic and natural alternatives to conventional treatment, such as ginger, tumeric, or other natural ingredients. Nevertheless, natural supplements have not been proven to significantly control the growth of acoustic neuromas.

• Chemotherapy is not a standard treatment for acoustic neuromas.
• Certain anti-cancer drugs have been shown to reduce tumor growth in laboratory studies, however this has not been demonstrated in patients.
• Current research does not show that there are any home or natural remedies effective in preventing or treating acoustic neuromas.

• Acoustic Neuroma Association 
• Acoustic Neuroma Association of Canada 
• British Acoustic Neuroma Association 
• Vestibular Disorders Association 
• Children’s Tumor Foundation 
• The Alexander Graham Bell Association for the Deaf and Hard of Hearing 
• Hearing Health Foundation 
• American Tinnitus Association