Enhanced chemotherapy delivery by intraarterial infusion and blood‐brain barrier disruption in the treatment of cerebral metastasis

Fortin, David; Gendron, Cathy; Boudrias, Marie; Garant, Marie-Pierre

doi:10.1002/cncr.22450

Cited by 73 publications

(38 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The latter is commonly used for BBBD in both animals and humans since its administration has been approved many years before the implementation of this technique. Since its initial description, the procedure has been used in preclinical and even clinical studies (34)(35)(36)(37).…”

Section: Osmotic Blood Brain Barrier Disruptionmentioning

confidence: 99%

Recent Advances in Blood–Brain Barrier Disruption as a CNS Delivery Strategy

Bellavance

Blanchette

Fortin

2008

AAPS J

Self Cite

159

109

View full text Add to dashboard Cite

Abstract. The blood-brain barrier (BBB) is a complex functional barrier composed of endothelial cells, pericytes, astrocytic endfeets and neuronal cells. This highly organized complex express a selective permeability for molecules that bear, amongst other parameters, adequate molecular weight and sufficient liposolubility. Unfortunately, very few therapeutic agents currently available do cross the BBB and enters the CNS. As the BBB limitation is more and more acknowledged, many innovative surgical and pharmacological strategies have been developed to circumvent it. This review focuses particularly on the osmotic opening of the BBB, a well-documented approach intended to breach the BBB. Since its inception by Rapoport in 1972, pre-clinical studies have provided important information on the extent of BBB permeation. Thanks to Neuwelt and colleagues, the osmotic opening of the BBB made its way to the clinic. However, many questions remain as to the detailed physiology of the procedure, and its best application to the clinic. Using different tools, amongst which MRI as a real-time in vivo characterization of the BBB permeability and CNS delivery, we attempt to better define the osmotic BBB permeabilization physiology. These ongoing studies are described, and data related to spatial and temporal distribution of a molecule after osmotic BBB breaching, as well as the window of BBB permeabilization, are discussed. We also summarize recent clinical series highlighting promising results in the application of this procedure to maximize delivery of chemotherapy in the treatment of brain tumor patients.KEY WORDS: blood-brain barrier, blood-brain barrier disruption, brain tumors, CNS delivery; MRI.

show abstract

Section: Osmotic Blood Brain Barrier Disruptionmentioning

confidence: 99%

Recent Advances in Blood–Brain Barrier Disruption as a CNS Delivery Strategy

Bellavance

Blanchette

Fortin

2008

AAPS J

Self Cite

159

109

View full text Add to dashboard Cite

show abstract

“…Previously published series have investigated the therapeutic efficacy of IA chemotherapy for treatment of brain tumors in both animal and clinical studies [6,[13][14][15][16][17]. However, numerous limitations prevented precise evaluation of IA chemotherapy therapeutic efficacy under clinical conditions.…”

Section: Introductionmentioning

confidence: 99%

Multiparametric MR imaging of tumor response to intraarterial chemotherapy in orthotopic xenograft models of human metastatic brain tumor

Kim

et al. 2016

J Neurooncol

View full text Add to dashboard Cite

The purpose of our study was to investigate the therapeutic efficacy of intraarterial (IA) chemotherapy via multiparametric magnetic resonance imaging (MRI) analysis in orthotopic mouse brain tumor models. Stereotactic-guided intracranial inoculation of MDA-MB-231 cells was performed in nude mice. Thirty tumor bearing mice were randomized into three groups, and each group received either IA docetaxel administration (n = 10), intravenous (IV) docetaxel administration (n = 10), or IA solvent injection (n = 10) as control. Treatment response was monitored by diffusion-weighted imaging and dynamic contrast enhanced-MRI obtained 1 day before and 8 days after therapy initiation. Imaging results were correlated with histopathology. In the results, IA chemotherapy showed a significant decrease in tumor volume (86.5 ± 15.6 %) compared to the IV chemotherapy (121.1 ± 39.6%) and control (126.2 ± 22.0%) 8 days after therapy (p < 0.05). Furthermore, IA chemotherapy resulted in a significant increase in mean tumor apparent diffusion coefficient (ADC) values (116.8 ± 44.9%); in contrary IV chemotherapy (66.6 ± 26.9%) and control (69.1 ± 29.5%) showed a significant decrease in ADC values corresponding to further tumor growth (p < 0.05). However, there was no significant difference in perfusion parameters including initial area under the curve, K(trans), K(ep), and V(e) between the groups (p > 0.05). Histopathology confirmed necrosis and necroptosis in the tumors after IA chemotherapy. In conclusion, IA chemotherapy may lead to effective inhibition of tumor cell proliferation and offer potential benefit of inducing higher degree of treatment response than IV chemotherapy.

show abstract

“…The idea behind this approach was to break down the barrier temporarily by an osmotic disruption [77]. The disruption could also be broken down by MRI-guided focused ultrasound BBB disruption technique [78].…”

Section: Invasive Methodsmentioning

confidence: 99%

Central nervous system diseases and the role of the blood-brain barrier in their treatment

Domínguez¹,

Álvarez²,

Hilario³

et al. 2013

Neurosci Discov

View full text Add to dashboard Cite

The Neurodegenerative diseases, cancer and infections of the brain are becoming more prevalent in society as population become older. Nowadays, these diseases represent a major medical challenge, so neuroprotective therapeutics have the potential to play a key role in managing this growing global burden of long-term neurological care. Despite major advances in neuroscience, treatment for these diseases is still a challenging area due to the presence of the blood-brain barrier. Conventional therapeutics remain critically below levels of optimum therapeutic efficacy, since the blood-brain barrier ensures that many potential therapeutics cannot reach the central nervous system. Hence, the current challenge is to develop drug-delivery systems which ensure that drugs cross the blood brain barrier in a safe and effective manner. Robust methods to assess Central Nervous System permeation are therefore essential for drug discovery. Drug candidates can be successfully designed to cross the blood-brain barrier, but for those that can't cross it, a delivery system that facilitates the movement of drug candidate across the barrier may possibly enable this entry. In order to assess the drug capacity to cross the brain, animal models of neurological disorders are increasingly employed. This review focuses on the properties of the blood-brain barrier that restrict drug delivery to the brain as well as on some of the most hopeful strategies developed to study and enhance drug delivery across the blood-brain barrier.

show abstract

Enhanced chemotherapy delivery by intraarterial infusion and blood‐brain barrier disruption in the treatment of cerebral metastasis

Cited by 73 publications

References 50 publications

Recent Advances in Blood–Brain Barrier Disruption as a CNS Delivery Strategy

Recent Advances in Blood–Brain Barrier Disruption as a CNS Delivery Strategy

Multiparametric MR imaging of tumor response to intraarterial chemotherapy in orthotopic xenograft models of human metastatic brain tumor

Central nervous system diseases and the role of the blood-brain barrier in their treatment

Contact Info

Product

Resources

About