Neurosurgical delivery of chemotherapeutics, targeted toxins, genetic and viral therapies in neuro-oncology.
Local delivery of biologic agents, such as gene and viruses, has been tested preclinically with encouraging success, and in some instances clinical trials have also been performed. In addition, the positive pressure infusion of various therapeutic agents is undergoing human testing and approval has already been granted for routine clinical use of biodegradable implants that diffuse a chemotherapeutic agent into peritumoral regions. Safety in glioma patients has been shown, but anticancer efficacy needs additional refinements in the technologies employed. In this review, we will describe these modalities and provide a perspective on needed improvements that should render them more successful.
Chiocca
E Antonio
EA
Molecular Neuro-Oncology Laboratories, Neurosurgery Service, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
Broaddus
William C
WC
Gillies
George T
GT
Visted
Therese
T
Lamfers
Martine L M
ML
D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001932:Brain Neoplasms / Q000235:genetics / Q000628:therapy* / Q000821:virology; D003588:Cytopathogenic Effect, Viral; D016503:Drug Delivery Systems; D018014:Gene Transfer Techniques; D015316:Genetic Therapy / Q000379:methods*; D005822:Genetic Vectors / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D000922:Immunotoxins / Q000008:administration & dosage*; D008495:Medical Oncology; D019635:Neurosurgical Procedures; D014780:Viruses / Q000472:pathogenicity*
D000970:Antineoplastic Agents; D000922:Immunotoxins