Case Report: Chemotherapy in Conjunction With Blood–Brain Barrier Disruption for a Patient With Germ Cell Tumor With Multiple Brain Metastases

Knuutinen, Oula; Kuitunen, Hanne; Alahuhta, Seppo; Isokangas, Juha-Matti; Sonkajärvi, Eila; Turpeenniemi‐Hujanen, Taina; Kuittinen, Outi

doi:10.1016/j.clgc.2018.05.005

Cited by 7 publications

(4 citation statements)

References 24 publications

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“…In cancer patients, several approaches are being explored to improve brain penetration of drugs. Two methods are being developed to overcome the blood-brain barrier: (i) disruption of the blood-brain barrier, including intrathecal administration [11,12,116], intra-arterial administration [2,[117][118][119][120][121][122], mechanical disruption of the BBB using osmotherapy [123], radiation [124,125] or ultrasounds [126]; (ii) methods without disruption of the BBB, for instance nano functionalization of drugs to cross the BBB or intranasal administration [2,127]. To date, most clinical approaches use the intrathecal route with a lumbar or an Ommaya reservoir, since direct intrathecal injections of drugs have led to some clinical benefit for the treatment of carcinomatosis meningitidis and parenchymal brain metastases [11,12,128,129].…”

Section: Fcrnmentioning

confidence: 99%

The Pharmacology of Xenobiotics after Intracerebro Spinal Fluid Administration: Implications for the Treatment of Brain Tumors

Paris

Angeli

Bousquet

2021

IJMS

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The incidence of brain metastasis has been increasing for 10 years, with poor prognosis, unlike the improvement in survival for extracranial tumor localizations. Since recent advances in molecular biology and the development of specific molecular targets, knowledge of the brain distribution of drugs has become a pharmaceutical challenge. Most anticancer drugs fail to cross the blood–brain barrier. In order to get around this problem and penetrate the brain parenchyma, the use of intrathecal administration has been developed, but the mechanisms governing drug distribution from the cerebrospinal fluid to the brain parenchyma are poorly understood. Thus, in this review we discuss the pharmacokinetics of drugs after intrathecal administration, their penetration of the brain parenchyma and the different systems causing their efflux from the brain to the blood.

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Section: Fcrnmentioning

confidence: 99%

The Pharmacology of Xenobiotics after Intracerebro Spinal Fluid Administration: Implications for the Treatment of Brain Tumors

Paris

Angeli

Bousquet

2021

IJMS

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“…Kemoterapi dengan obat bisa larut dalam lemak seperti carmustine jika diberikan secara intra-arteri. Seperti yang ditunjukkan dalam uji coba carmustine intraarterial (Knuutinen et al, 2018). Pada pasien tumor otak yang diberi obat carmustine dengan dosis yang tinggi ternyata lebih buruk daripada mereka yang diberi carmustine secara intravena.…”

Section: Permasalahan Dalam Pengobatan Klinis Tumor Otakunclassified

Jurnal Review: Pengobatan Klinis Tumor Otak pada Orang Dewasa

Ghozali

2021

Phi: J. Phys. Edu. & Applied

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Peningkatan kasus baru penderita tumor khususnya tumor otak semakin bertambah setiap tahun dan menjadi penyebab kematian tertinggi serta kebanyakan penderita adalah orang dewasa antara usia 55 dan 64 tahun. Tumor otak merupakan kumpulan sel-sel abnormal yang tumbuh secara tidak wajar dan tidak terkendali. Oleh karena itu perlu adanya pengobatan klinis untuk mengatasi permasalahan ini dengan tindakan operasi operasi bedah, terapi radiasi dan kemoterapi. Dalam penelitian ini menggunakan metode deskriptif kualitatif yang bersumber dari berbagai referensi jurnal dan literatur review. Tujuan penelitian ini untuk memberikan pemahaman secara keseluruhan tentang tumor otak dan pengobatan klinis yang harus dilakukan pada orang dewasa. Berdasarkan penelitian ini dapat diperoleh pengetahuan yang mendalam pada tumor otak dan keberhasilan dalam pengobatannya yang terbukti bisa menghancurkan sel-sel tumor dan menambah waktu kelangsungan hidup. Untuk kedepannya, perlu adanya pengembangan mengenai pengobatan klinis baru yang lebih efektif dan lebih baik dari pengobatan sebelumnya, sehingga tidak menimbulkan gejala pasca pengobatan tersebut pada penderita tumor otak terutama orang dewasa. Hal ini perlu didukung dengan pola hidup sehat, sistem imunitas yang baik dan menjaga kesehatan.

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“…In clinical practice, the procedure includes an intra-arterial infusion of hypertonic solution of mannitol (25%) into a carotid or vertebral artery, followed by intra-arterial delivery of chemotherapy, for the treatment of brain tumors. Knuutinen et al [69] recently reported the case of a 25-year-old man with brain metastases of a germ cell tumor, progressing after standard treatments. After two months of osmotic BBB disruption with an intra-arterial association of carboplatin, cyclophosphamide, and etoposide, the patient achieved a complete, durable response.…”

Section: Mechanical Disruption Of the Blood-brain Barrier To Deliver mentioning

confidence: 99%

How to Make Anticancer Drugs Cross the Blood–Brain Barrier to Treat Brain Metastases

Angeli

Nguyễn

Janin

et al. 2019

IJMS

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The incidence of brain metastases has increased in the last 10 years. However, the survival of patients with brain metastases remains poor and challenging in daily practice in medical oncology. One of the mechanisms suggested for the persistence of a high incidence of brain metastases is the failure to cross the blood–brain barrier of most chemotherapeutic agents, including the more recent targeted therapies. Therefore, new pharmacological approaches are needed to optimize the efficacy of anticancer drug protocols. In this article, we present recent findings in molecular data on brain metastases. We then discuss published data from pharmacological studies on the crossing of the blood–brain barrier by anticancer agents. We go on to discuss future developments to facilitate drug penetration across the blood–brain barrier for the treatment of brain metastases among cancer patients, using physical methods or physiological transporters.

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Case Report: Chemotherapy in Conjunction With Blood–Brain Barrier Disruption for a Patient With Germ Cell Tumor With Multiple Brain Metastases

Cited by 7 publications

References 24 publications

The Pharmacology of Xenobiotics after Intracerebro Spinal Fluid Administration: Implications for the Treatment of Brain Tumors

The Pharmacology of Xenobiotics after Intracerebro Spinal Fluid Administration: Implications for the Treatment of Brain Tumors

Jurnal Review: Pengobatan Klinis Tumor Otak pada Orang Dewasa

How to Make Anticancer Drugs Cross the Blood–Brain Barrier to Treat Brain Metastases

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