Caffo Maria, Caruso Gerardo, Curcio Antonello, Laera Roberta, Crisafulli Concetta, Fazzari Elena, Passalacqua Marcello, Germanò Antonino
Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy.
Adv Exp Med Biol. 2023;1394:181-192. doi: 10.1007/978-3-031-14732-6_11.
The treatment of glioma remains one of the most interesting topics in neurooncology. Glioblastoma multiforme is the most aggressive and prevalent malignant brain tumor. Nowadays, technologies and new tools are helping the neurosurgeons to define a tailored surgery. However, there are few pharmaceutical strategies in operated and nonoperated patients. There are still few anticancer drugs approved by FDA and EMA. Moreover, these drugs are not so effective and have a lot of side effects due to their toxicity. Nanoparticles are a new strategy which could help to create and carry new drugs. In fact, NPs improve the pharmacokinetic properties of anticancer drugs, reduce side-effects, and increase drug half-life and its selectivity. Nanoparticle drug delivery system has been studied for targeting different molecular biomarkers and signaling pathways. Furthermore, the first problem of anticancer drugs in the treatment of gliomas is penetrating the blood brain barrier which represents an insurmountable wall for most of synthetic and natural particles. In the last 15 years, a lot of researches tried to design a perfect nanoparticle both able to cross blood-brain barrier and to selectively target glioma cells, unfortunately, without great results. In vivo human trials are still ongoing and many of them have already failed. In this chapter we evaluate the effectiveness of nanotechnologies in the treatment of brain tumors. There is not yet, currently, a nanoparticle drug designed for the treatment of gliomas approved by FDA and EMA. Advancements in discovery of molecular characteristics of tumors lead to the development of targeted nanoparticles that are tested in numerous in vitro and in vivo studies on gliomas. Novel and repurposed drugs, as well as novel drug combinations, have also been already studied but those are not included in this chapter because the carried drugs (active substances) are not included among the approved anticancer drug used in the treatment of gliomas.
胶质瘤的治疗仍然是神经肿瘤学中最受关注的话题之一。多形性胶质母细胞瘤是最具侵袭性和最常见的恶性脑肿瘤。如今，技术和新工具正在帮助神经外科医生制定个性化手术方案。然而，对于已接受手术和未接受手术的患者，药物治疗策略却很少。美国食品药品监督管理局（FDA）和欧洲药品管理局（EMA）批准的抗癌药物仍然很少。此外，这些药物效果不佳，且因其毒性会产生很多副作用。纳米颗粒是一种有助于研发和运载新药的新策略。事实上，纳米颗粒可改善抗癌药物的药代动力学特性，减少副作用，延长药物半衰期并提高其选择性。纳米颗粒药物递送系统已被用于靶向不同的分子生物标志物和信号通路。此外，抗癌药物在治疗胶质瘤时面临的首要问题是穿透血脑屏障，这对大多数合成颗粒和天然颗粒来说都是一道难以逾越的障碍。在过去15年里，许多研究试图设计出一种既能穿过血脑屏障又能选择性靶向胶质瘤细胞的完美纳米颗粒，但遗憾的是，成效不大。人体临床试验仍在进行中，其中许多已经失败。在本章中，我们评估了纳米技术在治疗脑肿瘤方面的有效性。目前，尚无FDA和EMA批准的用于治疗胶质瘤的纳米颗粒药物。肿瘤分子特征发现方面的进展促使了靶向纳米颗粒的研发，这些纳米颗粒正在众多关于胶质瘤的体外和体内研究中进行测试。新型药物、重新利用的药物以及新型药物组合也已得到研究，但本章未将其纳入，因为所运载的药物（活性物质）并不在治疗胶质瘤所使用的已批准抗癌药物之列。
