Ma Peipei, Li Yongkang, Gu Yingrui, Zeng Hui, Xiang Hongwei, Cao Zhenzhen, Han Yankun, Cui Yong, Liu Haixiao
Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China.
Basic Medical College of The Fourth Military Medical University, Xi'an, Shaanxi, China.
Front Pharmacol. 2025 Aug 21;16:1655241. doi: 10.3389/fphar.2025.1655241. eCollection 2025.
Glioma therapy faces substantial challenges primarily due to the restrictive nature of the blood-brain barrier (BBB), limiting effective drug penetration and reducing therapeutic efficacy. Recent advancements in novel drug delivery systems (DDS), including exosome-mediated carriers, drug conjugates, and ultrasound-assisted delivery, have demonstrated promising results in overcoming these limitations. Exosomes offer superior biocompatibility, efficient BBB crossing, and natural cellular targeting capabilities; drug conjugates enable highly selective drug delivery through tumor-specific ligands; and ultrasound-assisted systems transiently disrupt the BBB to permit greater drug entry. Despite encouraging preclinical and early clinical outcomes, significant translational barriers remain. Challenges such as exosome manufacturing scalability, conjugate stability, and immunogenicity, as well as the optimization of ultrasound protocols, must be thoroughly addressed to achieve clinical translation. Overcoming these hurdles requires ongoing multidisciplinary collaboration and rigorous clinical evaluation. Continued progress in refining these innovative DDS approaches holds the potential to markedly improve therapeutic outcomes and patient prognosis in glioma treatment.
胶质瘤治疗面临着重大挑战，主要是由于血脑屏障（BBB）的限制性，这限制了药物的有效渗透并降低了治疗效果。新型药物递送系统（DDS）的最新进展，包括外泌体介导的载体、药物偶联物和超声辅助递送，在克服这些限制方面已显示出有前景的结果。外泌体具有卓越的生物相容性、高效的血脑屏障穿越能力和天然的细胞靶向能力；药物偶联物能够通过肿瘤特异性配体实现高度选择性的药物递送；而超声辅助系统可短暂破坏血脑屏障以允许更多药物进入。尽管临床前和早期临床结果令人鼓舞，但仍存在重大的转化障碍。必须彻底解决诸如外泌体生产可扩展性、偶联物稳定性和免疫原性以及超声方案优化等挑战，以实现临床转化。克服这些障碍需要持续的多学科合作和严格的临床评估。在完善这些创新的药物递送系统方法方面的持续进展有可能显著改善胶质瘤治疗的疗效和患者预后。
