title: New methods for direct delivery of chemotherapy for treating brain tumors.
abstract: Despite advances in diagnostic imaging and drug discovery, primary malignant brain tumors remain fatal. Median survival for patients with the most severe forms is rarely past eight months. The severity of the disease and the lack of substantial improvement in patient survival demand that new approaches be explored in drug delivery to brain tumors. Recently, local delivery of chemotherapy to brain tumors has provided a way to circumvent the blood-brain barrier, allowing delivery of chemotherapy drugs directly to malignant cells in the brain. Two methods of local delivery have been developed: polymeric-controlled release and convection-enhanced delivery. Controlled release utilizes degradable or non-degradable polymers as carriers of chemotherapy; polymer implants or microparticles are implanted locally to introduce a sustained source of drug for periods of days or months. Convection-enhanced delivery employs the bulk flow of drugs dissolved in fluid, which is introduced intracranially using a catheter and pump. The convective fluid flow is capable of delivering drugs great distances within the brain, potentially treating invasive cells at a distance from the catheter infusion site. These two new delivery strategies are capable of delivering both standard chemotherapeutic drugs and new methods of anti-cancer therapy. Taken individually, or used in tandem, they represent a potential revolution in brain cancer treatment.
authors.affiliation: Department of Biomedical Engineering, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Sawyer
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Piepmeier
authors.forename: W Mark
authors.initials: WM
authors.lastname: Saltzman
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001672:Biocompatible Materials / Q000737:chemistry; D001932:Brain Neoplasms / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D004337:Drug Carriers; D016503:Drug Delivery Systems; D004343:Drug Implants; D005910:Glioma / Q000188:drug therapy*; D006801:Humans; D019344:Lactic Acid / Q000737:chemistry; D008855:Microscopy, Electron, Scanning; D009362:Neoplasm Metastasis; D011100:Polyglycolic Acid / Q000737:chemistry; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011108:Polymers / Q000737:chemistry; D011137:Polystyrenes / Q000737:chemistry
chemical_list: D000970:Antineoplastic Agents; D001672:Biocompatible Materials; D004337:Drug Carriers; D004343:Drug Implants; D011108:Polymers; D011137:Polystyrenes; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid