Convection-enhanced drug delivery for glioblastoma: a review

Introduction Convection-enhanced delivery (CED) is a method of targeted, local drug delivery to the central nervous system (CNS) that bypasses the blood-brain barrier (BBB) and permits the delivery of high-dose therapeutics to large volumes of interest while limiting associated systemic toxicities....

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Bibliographic Details
Published in:Journal of neuro-oncology 2021-02, Vol.151 (3), p.415-427
Main Authors: D’Amico, Randy S., Aghi, Manish K., Vogelbaum, Michael A., Bruce, Jeffrey N.
Format: Article
Language:English
Subjects:
Blood-brain barrier
Brain cancer
Central nervous system
Clinical trials
Convection
Drug delivery
Glioblastoma
Glioma
Medicine
Medicine & Public Health
Neurology
Oncology
Special Issue Dedicated to the 35th Anniversary of the AANS/CNS Joint Section on Tumors
Topic Review
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Summary:Introduction Convection-enhanced delivery (CED) is a method of targeted, local drug delivery to the central nervous system (CNS) that bypasses the blood-brain barrier (BBB) and permits the delivery of high-dose therapeutics to large volumes of interest while limiting associated systemic toxicities. Since its inception, CED has undergone considerable preclinical and clinical study as a safe method for treating glioblastoma (GBM). However, the heterogeneity of both, the surgical procedure and the mechanisms of action of the agents studied—combined with the additional costs of performing a trial evaluating CED—has limited the field’s ability to adequately assess the durability of any potential anti-tumor responses. As a result, the long-term efficacy of the agents studied to date remains difficult to assess. Materials and methods We searched PubMed using the phrase “convection-enhanced delivery and glioblastoma”. The references of significant systematic reviews were also reviewed for additional sources. Articles focusing on physiological and physical mechanisms of CED were included as well as technological CED advances. Results We review the history and principles of CED, procedural advancements and characteristics, and outcomes from key clinical trials, as well as discuss the potential future of this promising technique for the treatment of GBM. Conclusion While the long-term efficacy of the agents studied to date remains difficult to assess, CED remains a promising technique for the treatment of GBM.
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-020-03408-9