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Convection-Enhanced Delivery for Diffuse Intrinsic Pontine Glioma Treatment.

TitleConvection-Enhanced Delivery for Diffuse Intrinsic Pontine Glioma Treatment.
Publication TypeJournal Article
Year of Publication2017
AuthorsZhou Z, Singh R, Souweidane MM
JournalCurr Neuropharmacol
Volume15
Issue1
Pagination116-128
Date Published2017
ISSN1875-6190
KeywordsAnimals, Antineoplastic Agents, Brain Stem Neoplasms, Combined Modality Therapy, Convection, Drug Delivery Systems, Glioma, Humans, Tissue Distribution
Abstract

Convection-enhanced delivery (CED) is a technique designed to deliver drugs directly into the brain or tumors. Its ability to bypass the blood-brain barrier (BBB), one of the major hurdles in delivering drugs to the brain, has made it a promising drug delivery method for the treatment of primary brain tumors. A number of clinical trials utilizing CED of various therapeutic agents have been conducted to treat patients with supratentorial high-grade gliomas. Significant responses have been observed in certain patients in all of these trials. However, the insufficient ability to monitor drug distribution and pharmacokinetics hampers CED from achieving its potentials on a larger scale. Brainstem CED for diffuse intrinsic pontine glioma (DIPG) treatment is appealing because this tumor is compact and has no definitive treatment. The safety of brainstem CED has been established in small and large animals, and recently in early stage clinical trials. There are a few current clinical trials of brainstem CED in treating DIPG patients using targeted macromolecules such as antibodies and immunotoxins. Future advances for CED in DIPG treatment will come from several directions including: choosing the right agents for infusion; developing better agents and regimen for DIPG infusion; improving instruments and technique for easier and accurate surgical targeting and for allowing multisession or prolonged infusion to implement optimal time sequence; and better understanding and control of drug distribution, clearance and time sequence. CED-based therapies for DIPG will continue to evolve with new understanding of the technique and the disease.

DOI10.2174/1570159x14666160614093615
Alternate JournalCurr Neuropharmacol
PubMed ID27306036
PubMed Central IDPMC5327456