Benny Ofra, Pakneshan Pouya
Department of Surgery, Children's Hospital Boston, Harvard Medical School, MA, USA.
Cell Adh Migr. 2009 Apr-Jun;3(2):224-9. doi: 10.4161/cam.3.2.7766. Epub 2009 Apr 6.
Antiangiogenic therapies aimed at inhibiting the formation of tumor vasculature hold great promise for cancer therapy, with multiple compounds currently undergoing clinical trials. As with many forms of chemotherapy, antiangiogenic drugs face numerous hurdles in their translation to clinical use. Many such promising agents exhibit a short half-life, low solubility, poor bioavailability and multiple toxic side effects. Furthermore, when targeting malignant brain tumors the blood-brain barrier represents a formidable obstacle, preventing drugs from penetrating into the central nervous system (CNS). In this review, we discuss several preclinical antiangiogenic therapies and describe issues related to the unique conditions in the brain with regard to cancer treatment and neurotoxicity. We focus on the limitations of antiangiogenic drugs in the brain, along with numerous solutions that involve novel biomaterials and nanotechnological approaches. We also discuss an example in which modifying the properties of an antiangiogenic compound enhanced its clinical efficacy in treating tumors while simultaneously mitigating undesirable neurological side-effects.
旨在抑制肿瘤血管形成的抗血管生成疗法在癌症治疗方面前景广阔,目前有多种化合物正在进行临床试验。与许多化疗形式一样,抗血管生成药物在转化为临床应用时面临诸多障碍。许多这类有前景的药物半衰期短、溶解度低、生物利用度差且有多种毒副作用。此外,在靶向恶性脑肿瘤时,血脑屏障是一个巨大的障碍,阻止药物进入中枢神经系统(CNS)。在这篇综述中,我们讨论了几种临床前抗血管生成疗法,并描述了与脑部癌症治疗和神经毒性独特情况相关的问题。我们重点关注抗血管生成药物在脑部的局限性,以及涉及新型生物材料和纳米技术方法的众多解决方案。我们还讨论了一个例子,即改变抗血管生成化合物的特性可提高其治疗肿瘤的临床疗效,同时减轻不良神经副作用。