Chemotherapy in pediatric brain tumor and the challenge of the blood–brain barrier
Johid Reza Malik,
Anthony T. Podany,
Parvez Khan
et al.
Abstract:BackgroundPediatric brain tumors (PBT) stand as the leading cause of cancer‐related deaths in children. Chemoradiation protocols have improved survival rates, even for non‐resectable tumors. Nonetheless, radiation therapy carries the risk of numerous adverse effects that can have long‐lasting, detrimental effects on the quality of life for survivors. The pursuit of chemotherapeutics that could obviate the need for radiotherapy remains ongoing. Several anti‐tumor agents, including sunitinib, valproic acid, carb… Show more
“…It is composed of various cell types, including endothelial cells, astrocytes, podocytes, pericytes, microglia, oligodendrocytes and neurons ( 36 , 37 ). The blood-brain barrier, with its stringent architecture and selective permeability, serves as a protective shield for both children and adults, safeguarding the brain’s microenvironment and the central nervous system’s stability ( 38 ).…”
Section: Mechanism Of Gc Brain Metastasismentioning
confidence: 99%
“…Chemotherapy is the most common treatment for gastric cancer, as it can alleviate systemic symptoms and improve the quality of life. It is a safe and promising treatment for patients with brain metastasis of gastric cancer ( 38 ).…”
Section: Treatment Of Gc Brain Metastasismentioning
Gastric cancer is one of the cancers with increasing incidence and ranks fourth globally among the most frequent causes of cancer-related mortality. Early gastric cancer is often asymptomatic or presents with atypical symptoms, and the majority of patients present with advanced disease upon diagnosis. Brain metastases are present in approximately 1% of gastric cancer patients at the time of diagnosis, which significantly contributed to the overall mortality of the disease worldwide. Conventional therapies for patients with brain metastases remain limited and the median overall survival of patients is only 8 months in advanced cases. Recent studies have improved our understanding of the molecular mechanisms underlying gastric cancer brain metastases, and immunotherapy has become an important treatment option in combination with radiotherapy, chemotherapy, targeted therapy and surgery. This review aims to provide insight into the cellular processes involved in gastric cancer brain metastases, discuss diagnostic approaches, evaluate the integration of immune checkpoint inhibitors into treatment and prognosis, and explore the predictive value of biomarkers in immunotherapy.
“…It is composed of various cell types, including endothelial cells, astrocytes, podocytes, pericytes, microglia, oligodendrocytes and neurons ( 36 , 37 ). The blood-brain barrier, with its stringent architecture and selective permeability, serves as a protective shield for both children and adults, safeguarding the brain’s microenvironment and the central nervous system’s stability ( 38 ).…”
Section: Mechanism Of Gc Brain Metastasismentioning
confidence: 99%
“…Chemotherapy is the most common treatment for gastric cancer, as it can alleviate systemic symptoms and improve the quality of life. It is a safe and promising treatment for patients with brain metastasis of gastric cancer ( 38 ).…”
Section: Treatment Of Gc Brain Metastasismentioning
Gastric cancer is one of the cancers with increasing incidence and ranks fourth globally among the most frequent causes of cancer-related mortality. Early gastric cancer is often asymptomatic or presents with atypical symptoms, and the majority of patients present with advanced disease upon diagnosis. Brain metastases are present in approximately 1% of gastric cancer patients at the time of diagnosis, which significantly contributed to the overall mortality of the disease worldwide. Conventional therapies for patients with brain metastases remain limited and the median overall survival of patients is only 8 months in advanced cases. Recent studies have improved our understanding of the molecular mechanisms underlying gastric cancer brain metastases, and immunotherapy has become an important treatment option in combination with radiotherapy, chemotherapy, targeted therapy and surgery. This review aims to provide insight into the cellular processes involved in gastric cancer brain metastases, discuss diagnostic approaches, evaluate the integration of immune checkpoint inhibitors into treatment and prognosis, and explore the predictive value of biomarkers in immunotherapy.
Glioblastoma remains a devastating disease with a bleak prognosis despite continued research and numerous clinical trials. Convection-enhanced delivery offers researchers and clinicians a platform to bypass the blood–brain barrier and administer drugs directly to the brain parenchyma. While not without significant technological challenges, convection-enhanced delivery theoretically allows for a wide range of therapeutic agents to be delivered to the tumoral space while preventing systemic toxicities. This article provides a comprehensive review of the antitumor agents studied in clinical trials of convection-enhanced delivery to treat adult high-grade gliomas. Agents are grouped by classes, and preclinical evidence for these agents is summarized, as is a brief description of their mechanism of action. The strengths and weaknesses of each clinical trial are also outlined. By doing so, the difficulty of untangling the efficacy of a drug from the technological challenges of convection-enhanced delivery is highlighted. Finally, this article provides a focused review of some therapeutics that might stand to benefit from future clinical trials for glioblastoma using convection-enhanced delivery.
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