Local treatment of malignant brain tumors using implantable chemotherapeutic polymers.
Malignant gliomas are among the most devastating human cancers. The infiltrating nature of these malignancies makes complete surgical resection nearly impossible. Conventional therapy for malignant gliomas consists primarily of surgical debulking followed by radiation therapy and possibly chemotherapy. The major factor limiting intracranial therapeutic levels of systemically administered chemotherapeutics is the physiologic barriers of the brain. This has led to the development of novel methods of drug delivery such as implantable polymers containing chemotherapeutic agents. Several phase III clinical trials show that implantation of carmustine-containing biodegradable polymers prolongs survival in patients with both recurrent and newly diagnosed malignant gliomas. In this article, we summarize these trials and discuss ongoing clinical trials involving implantable chemotherapy-containing polymers in the treatment of patients with malignant gliomas.
Gallia
Gary L
GL
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
Brem
Steven
S
Brem
Henry
H
D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000627:therapeutic use; D001672:Biocompatible Materials; D001673:Biodegradation, Environmental; D001932:Brain Neoplasms / Q000188:drug therapy*; D002330:Carmustine / Q000008:administration & dosage / Q000627:therapeutic use; D005910:Glioma / Q000188:drug therapy*; D006801:Humans; D011108:Polymers; D019736:Prostheses and Implants
D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D001672:Biocompatible Materials; D011108:Polymers; D002330:Carmustine