title: Local delivery of chemotherapy prolongs survival in experimental brain metastases from breast carcinoma.
abstract: OBJECTIVE
  Despite improved systemic control of metastatic breast cancer, the incidence of brain metastases from breast carcinoma continues to rise, in part because most systemically administered agents have poor central nervous system penetration. Therefore, as a method of optimizing drug delivery into the central nervous system, we studied the safety and efficacy of chemotherapy delivered locally via biodegradable polymers in a mouse model of breast carcinoma metastases to the brain.
  
  
  METHODS
  The chemotherapeutic agents carmustine (BCNU), carboplatin, and camptothecin were incorporated into controlled release polymers and tested individually against intracranial challenges of EMT-6 breast tumor in BALB/c female mice. For each drug, four groups were tested: Group 1, empty polymer (no drug); Group 2, external beam radiotherapy (XRT) alone; Group 3, local chemotherapy from biodegradable polymer alone; and Group 4, local chemotherapy and XRT together. Polymers were implanted 5 days after intracranial tumor inoculation; XRT was administered on Days 7 through 9 (300 cGy/d).
  
  
  RESULTS
  BCNU polymer alone (n = 10; median survival time, >200 d; P < 0.0001) and BCNU and XRT together (n = 10; median survival time, 41 d; P = 0.02) significantly improved survival in mice with intracranial EMT-6 breast cancer in comparison with control animals (n = 20; median survival time, 17 d). Carboplatin and camptothecin, either with or without XRT, and XRT alone did not have any significant effect on survival.
  
  
  CONCLUSIONS
  Local delivery of BCNU with biodegradable polymers can significantly prolong survival in a murine model of intracranial metastatic breast cancer. Surgical resection and placement of BCNU polymers into the resection cavity may decrease the incidence of local recurrence of breast cancer metastases with minimal morbidity.
authors.affiliation: Division of Neurological Surgery, University of North Carolina, Chapel Hill, USA.
authors.forename: M G
authors.initials: MG
authors.lastname: Ewend
authors.forename: P
authors.initials: P
authors.lastname: Sampath
authors.forename: J A
authors.initials: JA
authors.lastname: Williams
authors.forename: B M
authors.initials: BM
authors.lastname: Tyler
authors.forename: H
authors.initials: H
authors.lastname: Brem
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000494:pharmacology*; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary*; D002166:Camptothecin / Q000494:pharmacology; D016190:Carboplatin / Q000494:pharmacology; D002330:Carmustine / Q000494:pharmacology; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003692:Delayed-Action Preparations; D004343:Drug Implants; D005260:Female; D015552:Injections, Intralesional; D008325:Mammary Neoplasms, Experimental / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D051379:Mice; D008807:Mice, Inbred BALB C; D009368:Neoplasm Transplantation; D011108:Polymers; D014407:Tumor Cells, Cultured / Q000187:drug effects / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents; D003692:Delayed-Action Preparations; D004343:Drug Implants; D011108:Polymers; D016190:Carboplatin; D002330:Carmustine; D002166:Camptothecin