Department of Neurological Surgery, The Ohio State University Wexner Medical Center, The Ohio State University, N1019 Doan Hall, 410 W 10Th Avenue, Columbus, OH, 43210, USA.
J Neurooncol. 2024 Jan;166(2):243-255. doi: 10.1007/s11060-023-04552-8. Epub 2024 Jan 23.
Malignant gliomas are a therapeutic challenge and remain nearly uniformly fatal. While new targeted chemotherapeutic agentsagainst malignant glioma have been developed in vitro, these putative therapeutics have not been translated into successful clinical treatments. The lack of clinical effectiveness can be the result of ineffective biologic strategies, heterogeneous tumor targets and/or the result of poortherapeutic distribution to malignant glioma cells using conventional nervous system delivery modalities (intravascular, cerebrospinal fluid and/orpolymer implantation), and/or ineffective biologic strategies.
The authors performed a review of the literature for the terms "convection enhanced delivery", "glioblastoma", and "glioma". Selectclinical trials were summarized based on their various biological mechanisms and technological innovation, focusing on more recently publisheddata when possible.
We describe the properties, features and landmark clinical trials associated with convection-enhanced delivery for malignant gliomas.We also discuss future trends that will be vital to CED innovation and improvement.
Efficacy of CED for malignant glioma to date has been mixed, but improvements in technology and therapeutic agents arepromising.
恶性脑胶质瘤是一种治疗上的挑战,几乎普遍致命。虽然已经在体外开发出针对恶性脑胶质瘤的新靶向化疗药物,但这些潜在的治疗方法尚未转化为成功的临床治疗。缺乏临床疗效可能是由于生物策略无效、肿瘤靶标异质性以及使用传统的神经系统给药方式(血管内、脑脊液和/或聚合物植入)向恶性脑胶质瘤细胞的治疗分布不佳,以及/或生物策略无效所致。
作者对“对流增强递送”、“脑胶质瘤”和“神经胶质瘤”这几个术语进行了文献回顾。根据其各种生物学机制和技术创新,对选定的临床试验进行了总结,重点关注了最近发表的数据。
我们描述了与恶性脑胶质瘤的对流增强递送相关的特性、特征和具有里程碑意义的临床试验。我们还讨论了对流增强递送创新和改进至关重要的未来趋势。
迄今为止,对流增强递送治疗恶性脑胶质瘤的疗效喜忧参半,但技术和治疗药物的改进前景看好。