Intra-arterial chemotherapy of brain cancers

The brain-blood barrier is considered  to be a major obstacle for delivering chemotherapy to brin tumors and obtaining durable disease control in patients with high-grade gliomas. Intra-arterial drug injection after selective catheterization of cerebral arteries has been performed in some small clinical trials in order to achieve higher drug concentration in the tumor while minimizing systemic exposure. This approach has potentail which has not yet been demonstrated.

A recent review of studies with intra-arterial administration of nitrosoureas and platinum derivatives, as well as the principal aspects and perspectives of the new strategy of blood–brain barrier disruption with osmotic agents or bradykinin analogs demonstrated no superiority of intra-arterial chemotherapy over its intravenous counterpart . It concluded that although the incidence of serious neurotoxicity is reduced with teh intra-arterial route, the risk of  acute complication still contraindicates internal carotid or vertebral artery catheterization for chemotherapy administration outside the setting of well-controlled clinical trials.

IUmberto Basso, Sara Lonardi, Alba A Brandes, Is intra-arterial chemotherapy useful in high-grade gliomas? Expert Review of Anticancer Therapy
October 2002, Vol. 2, No. 5, Pages 507-519

Herbert B. Newton. (2005) Intra-arterial chemotherapy of primary brain tumors. Current Treatment Options in Oncology 6:6, 519-530

CrossRef Maciej M Mrugala, Santosh Kesari, Naren Ramakrishna, Patrick Y Wen. (2004) Therapy for recurrent malignant glioma in adults. Expert Review of Anticancer Therapy 4:5, 759-782

Comments

[Brian S]

The nitrosoureas and platinum derivatives are relatively small molecules. I wonder if the same conclusions would be reached with the much larger monoclonal antibodies?