i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; INEB-Instituto Nacional de Engenharia Biomédica, Universidade do Porto, Porto, Portugal; ICBAS-Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; CESPU-Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra, Portugal.
CESPU-Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra, Portugal.
Adv Protein Chem Struct Biol. 2018;112:61-80. doi: 10.1016/bs.apcsb.2018.03.001. Epub 2018 Mar 30.
Glioblastoma multiforme (GBM) is the most common and challenging primary malignant brain tumor, being the median overall survival between 10 and 14 months due to its invasive characteristics. GBM treatment is mainly based on the maximal surgical resection and radiotherapy associated to chemotherapy. Monoclonal antibodies (mAbs) have been used in chemotherapy protocols for GBM treatment in order to improve immunotherapy and antiangiogenic processes. High specificity and affinity of mAbs for biological targets make them highly used for brain tumor therapy. Specifically, antiangiogenic mAbs have been wisely indicated in chemotherapy protocols because GBM is the most vascularized tumors in humans with high expression of cytokines. However, mAb-based therapy is not that effective due to the aggressive spread of the tumor associated to the difficulty in the access of mAb into the brain (due to the blood-brain barrier). For that reason, nanobiotechnology has played an important role in the treatment of several tumors, mainly in the tumors of difficult access, such as GBM. In this chapter will be discussed strategies related with nanobiotechnology applied to the mAb delivery and how these therapeutics can improve the GBM treatment and life quality of the patient.
多形性胶质母细胞瘤(GBM)是最常见和最具挑战性的原发性恶性脑肿瘤,由于其侵袭性特征,中位总生存期在 10 到 14 个月之间。GBM 的治疗主要基于最大限度的手术切除和放射治疗联合化疗。单克隆抗体(mAbs)已被用于 GBM 的化疗方案中,以改善免疫治疗和抗血管生成过程。mAbs 对生物靶标的高特异性和亲和力使其在脑肿瘤治疗中得到广泛应用。具体来说,抗血管生成 mAbs 已被明智地应用于化疗方案中,因为 GBM 是人类中血管化程度最高的肿瘤,细胞因子表达水平高。然而,由于肿瘤的侵袭性扩散以及 mAb 进入大脑的难度(由于血脑屏障),mAb 为基础的治疗并不那么有效。为此,纳米生物技术在治疗多种肿瘤方面发挥了重要作用,主要是在治疗难以到达的肿瘤方面,如 GBM。本章将讨论与纳米生物技术相关的策略,这些策略应用于 mAb 的递送来提高 GBM 的治疗效果和患者的生活质量。