Local strategies and delivery systems for the treatment of malignant gliomas

J Drug Target. 2019 Apr;27(4):367-378. doi: 10.1080/1061186X.2018.1509982. Epub 2018 Sep 19.

Abstract

Glioma is one of the most common type of malignant tumours with high morbidity and mortality rates. Due to the particular features of the brain, such as blood-brain barrier or blood-tumour barrier, therapeutic agents are ineffective by systemic administration. The tumour inevitably recurs and devitalises patients. Herein, an overview of the localised gliomas treatment strategies is provided, including direct intratumoural/intracerebral injection, convection-enhanced delivery, and the implant of biodegradable polymer systems. The advantages and disadvantages of each therapy are discussed. Subsequently, we have reviewed the recent developments of therapeutic delivery systems aimed at transporting sufficient amounts of antineoplastic drugs into the brain tumour sites while minimising the potential side effects. To treat gliomas, localised and controlled delivery of drugs at their desired site of action is preferred as it reduces toxicity and increases treatment efficiency. Simultaneously, various drug delivery systems (DDS) have been used to enhance drug delivery to the brain. Use of non-conventional DDS for localised therapy has greatly expanded the spectrum of drugs available for the treatment of malignant tumours. Use smart DDS via localised delivery strategies, in combination with radiotherapy and multiple drug loading would serve as a promising approach to treat gliomas.

Keywords: Direct injection; convection-enhanced delivery; drug delivery systems; glioma; implant; localised therapy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / pharmacokinetics
  • Blood-Brain Barrier / metabolism
  • Brain Neoplasms / drug therapy*
  • Drug Delivery Systems*
  • Glioma / drug therapy*
  • Humans
  • Polymers / chemistry
  • Tissue Distribution

Substances

  • Antineoplastic Agents
  • Polymers