Brain tumor is abnormal growth of cells in or around the brain. Prevalence of brain tumor that metastasizes is one-fourth of all type of cancer. In cancer patients, chances of generation of metastatic brain tumors is 10-15 per one lac. The occurrence of malignant gliomas is around 5 to 10% in the same population. In malignant glioma, the different pathway is involved in development and progression. It carries a bleak prognosis and often recurs even after standard treatment modalities. Wnt signaling pathway, growth factors, MMPs/TIMPs and drug metabolizing enzyme genes have been reported to show a role in the initiation, progression, and metabolism of drugs in patients with brain tumor. Hence, the aim of this review is to briefly discuss the impact of genetic and epigenetic variations within Wnt signaling pathway, matrix metalloproteinases (MMPs), growth factors, cytokines and drug metabolizing enzyme genes in patients with brain cancer. Description of certain inherited and acquired genetic variations in the genes involved in the initiation, progression, and metabolism of drugs within a given individual will be important to improve the choice of medication in astrocytoma patients.