Raza Shaan M, Pradilla Gustavo, Legnani Federico G, Thai Quoc Anh, Olivi Alessandro, Weingart Jon D, Brem Henry
Department of Neurological Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 7-113, Baltimore, MD 21287, USA.
Expert Opin Biol Ther. 2005 Apr;5(4):477-94. doi: 10.1517/14712598.5.4.477.
Recent advances in the treatment of malignant brain tumours have focused on the development of targeted local delivery of therapeutic agents, which combine various antineoplastic strategies that include cytotoxic, anti-angiogenic and immunomodulatory mechanisms, among others. The introduction of local delivery devices for sustained administration of antineoplastic agents represents a new opportunity to effectively treat these malignancies by facilitating the intracranial administration of safe and clinically efficacious doses for prolonged periods of time in a controlled fashion. This technology circumvents the need for high systemic doses with potentially harmful toxicities, bypasses the blood-brain barrier and can be tailored to deliver new agents with complex pharmacological properties. Based on local delivery strategies, new delivery systems, including convection-enhanced delivery and microchips, have been developed. As a result, recent advances in tumour biology have been adopted as potentially translatable treatments and are undergoing preclinical and clinical evaluation at present. These novel approaches could improve the prognosis of patients with these tumours.
恶性脑肿瘤治疗的最新进展集中在治疗药物的靶向局部递送的发展上,这些治疗药物结合了多种抗肿瘤策略,包括细胞毒性、抗血管生成和免疫调节机制等。用于持续施用抗肿瘤药物的局部递送装置的引入,为有效治疗这些恶性肿瘤提供了新机会,通过以可控方式长时间促进安全且临床有效的剂量的颅内给药。该技术避免了使用具有潜在有害毒性的高全身剂量的需要,绕过了血脑屏障,并且可以定制以递送具有复杂药理特性的新药物。基于局部递送策略,已经开发了新的递送系统,包括对流增强递送和微芯片。因此,肿瘤生物学的最新进展已被用作潜在的可转化治疗方法,目前正在进行临床前和临床评估。这些新方法可能会改善这些肿瘤患者的预后。