Rolfe Nathaniel W, Dadario Nicholas B, Canoll Peter, Bruce Jeffrey N
Department of Neurological Surgery, Columbia University Irving Medical Center/NY-Presbyterian Hospital, New York, NY 10032, USA.
Department of Pathology and Cell Biology, Columbia University Irving Medical Center/NY-Presbyterian Hospital, New York, NY 10032, USA.
Pharmaceuticals (Basel). 2024 Jul 23;17(8):973. doi: 10.3390/ph17080973.
Glioblastoma remains a devastating disease with a bleak prognosis despite continued research and numerous clinical trials. Convection-enhanced delivery offers researchers and clinicians a platform to bypass the blood-brain barrier and administer drugs directly to the brain parenchyma. While not without significant technological challenges, convection-enhanced delivery theoretically allows for a wide range of therapeutic agents to be delivered to the tumoral space while preventing systemic toxicities. This article provides a comprehensive review of the antitumor agents studied in clinical trials of convection-enhanced delivery to treat adult high-grade gliomas. Agents are grouped by classes, and preclinical evidence for these agents is summarized, as is a brief description of their mechanism of action. The strengths and weaknesses of each clinical trial are also outlined. By doing so, the difficulty of untangling the efficacy of a drug from the technological challenges of convection-enhanced delivery is highlighted. Finally, this article provides a focused review of some therapeutics that might stand to benefit from future clinical trials for glioblastoma using convection-enhanced delivery.
尽管持续开展了研究并进行了大量临床试验，但胶质母细胞瘤仍然是一种预后不佳的毁灭性疾病。对流增强给药为研究人员和临床医生提供了一个绕过血脑屏障并将药物直接输送到脑实质的平台。虽然并非没有重大技术挑战，但对流增强给药理论上允许将多种治疗剂输送到肿瘤空间，同时防止全身毒性。本文全面综述了在对流增强给药治疗成人高级别胶质瘤的临床试验中研究的抗肿瘤药物。药物按类别分组，总结了这些药物的临床前证据，并简要描述了它们的作用机制。还概述了每项临床试验的优缺点。通过这样做，突出了将药物疗效与对流增强给药的技术挑战区分开来的难度。最后，本文重点综述了一些可能受益于未来使用对流增强给药治疗胶质母细胞瘤的临床试验的疗法。
