School of Pharmacy, The University of Queensland, Brisbane, QLD 4102, Australia.
Children's Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW 2031, Australia; School of Women's and Children's Health, UNSW Sydney, Sydney, NSW 2052, Australia; ARC Centre of Excellence in Convergent Bio-Nano Science and Technology and Australian Centre for Nanomedicine, UNSW Sydney, Sydney, NSW 2052, Australia.
Adv Drug Deliv Rev. 2021 Apr;171:108-138. doi: 10.1016/j.addr.2021.01.012. Epub 2021 Jan 21.
Glioblastoma (GBM) is one of the most aggressive cancers of the brain. Despite extensive research over the last several decades, the survival rates for GBM have not improved and prognosis remains poor. To date, only a few therapies are approved for the treatment of GBM with the main reasons being: 1) significant tumour heterogeneity which promotes the selection of resistant subpopulations 2) GBM induced immunosuppression and 3) fortified location of the tumour in the brain which hinders the delivery of therapeutics. Existing therapies for GBM such as radiotherapy, surgery and chemotherapy have been unable to reach the clinical efficacy necessary to prolong patient survival more than a few months. This comprehensive review evaluates the current and emerging therapies including those in clinical trials that may potentially improve both targeted delivery of therapeutics directly to the tumour site and the development of agents that may specifically target GBM. Particular focus has also been given to emerging delivery technologies such as focused ultrasound, cellular delivery systems nanomedicines and immunotherapy. Finally, we discuss the importance of developing novel materials for improved delivery efficacy of nanoparticles and therapeutics to reduce the suffering of GBM patients.
胶质母细胞瘤（GBM）是最具侵袭性的脑癌之一。尽管在过去几十年中进行了广泛的研究，但 GBM 的生存率并未提高，预后仍然较差。迄今为止，只有少数几种疗法被批准用于治疗 GBM，主要原因是：1）肿瘤异质性显著，促进了耐药亚群的选择；2）GBM 诱导的免疫抑制；3）肿瘤在大脑中的强化位置，阻碍了治疗药物的输送。现有的 GBM 治疗方法，如放疗、手术和化疗，都无法达到延长患者生存时间超过几个月的必要临床疗效。本综述评估了目前和新兴的治疗方法，包括临床试验中的那些方法，这些方法可能有助于提高治疗药物直接靶向肿瘤部位的靶向递送，并开发可能专门针对 GBM 的药物。特别关注了新兴的输送技术，如聚焦超声、细胞输送系统、纳米医学和免疫疗法。最后，我们讨论了开发新型材料以提高纳米颗粒和治疗药物的输送效果的重要性，以减轻 GBM 患者的痛苦。
