Introduction

Intra-arterial (lA) delivery of therapeutic agents across the blood-brain barrier (BBB) is an evolving strategy which enables the distribution of high concentration therapeutics through a targeted vascular territory, while potentially limiting systemic toxicity. Studies have demonstrated lA methods to be safe and efficacious for a variety of therapeutics. However, further characterization of the clinical efficacy of lA therapy for the treatment of brain tumors and refinement of its potential applications are necessary.

Methods

We have reviewed the preclinical and clinical evidence supporting superselective intraarterial cerebral infusion (SSJACI) with BBB disruption for the treatment of brain tumors. In addition, we review ongoing clinical trials expanding the applicability and investigating the efficacy of lA therapy for the treatment of brain tumors.

Results

Trends in recent studies have embraced the use of SSIACI and less neurotoxic chemotherapies. The majority of trials continue to use mannitol as the preferred method of hyperosmolar BBB disruption. Recent preclinical and preliminary human investigations into the lA delivery of Bevacizumab have demonstrated its safety and efficacy as an anti-tumor agent both alone and in combination with chemotherapy.

Conclusion

lA drug delivery may significantly affect the way treatment are delivered to patients with brain tumors, and in particular GBM. With refinement and standardization of the techniques of lA drug delivery, improved drug selection and formulations, and the development of methods to minimize treatment-related neurological injury, lA therapy may offer significant benefits for the treatment of brain tumors.

中文翻译：

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神经肿瘤学中的聚焦超声：聚焦超声基金会在推动采用和创新中的作用

介绍

跨血脑屏障 (BBB) 的动脉内 (IA) 递送治疗剂是一种不断发展的策略，它使高浓度治疗剂能够通过目标血管区域分布，同时可能限制全身毒性。研究表明，IA 方法对于多种治疗是安全和有效的。然而，有必要进一步表征 1A 疗法治疗脑肿瘤的临床疗效并改进其潜在应用。

方法

我们回顾了支持超选择性动脉内脑灌注 (SSJACI) 与 BBB 中断治疗脑肿瘤的临床前和临床证据。此外，我们回顾了正在进行的临床试验，以扩大适用性并调查 LA 疗法治疗脑肿瘤的疗效。

结果

最近的研究趋势包括使用 SSIACI 和较少神经毒性的化学疗法。大多数试验继续使用甘露醇作为破坏高渗 BBB 的首选方法。最近对贝伐单抗 IA 给药的临床前和初步人体研究证明了其作为抗肿瘤剂的安全性和有效性，无论是单独使用还是与化疗联合使用。

结论

l 药物输送可能会显着影响对脑肿瘤患者的治疗方式，尤其是GBM。随着 LA 药物递送技术的改进和标准化、药物选择和配方的改进，以及最大限度地减少与治疗相关的神经损伤的方法的开发，LA 疗法可能为脑肿瘤的治疗提供显着的益处。