Interstitial Docetaxel (Taxotere), Carmustine and Combined Interstitial Therapy: a Novel Treatment for Experimental Malignant Glioma

Sampath, Prakash; Rhines, Laurence D.; DiMeco, Francesco; Tyler, Betty; Park, Michael C.; Brem, Henry

doi:10.1007/s11060-006-9159-4

Cited by 32 publications

(15 citation statements)

References 36 publications

(45 reference statements)

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“…Herein, each factor requires different time scales and concentration profiles because of the nature of the repair/inhibition process. This suggests that the sequential or coupled release of multiple factors with different temporal profiles will become essential and critical for a successful tissue regeneration or tumor inhibition strategy 1–12. However, in modern design, most delivery systems only accounts for a single factor, limiting the overall efficacy of the therapy 13–19.…”

Section: Introductionmentioning

confidence: 99%

Core/shell microspheres via coaxial electrohydrodynamic atomization for sequential and parallel release of drugs

Nie

Zhou

Arifin

et al. 2010

J Biomedical Materials Res

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Herein, it is demonstrated that coaxial electrohydrodynamic atomization can be used for the fabrication of microspheres with distinct core/shell structure. This allows the encapsulation of two different types of drugs in different compartments in one single step. In Group A, we prepared microspheres in which the core and the shell contain hydrophobic and hydrophilic drugs, respectively. In contrast, in Group B, the opposite is prepared. While the former can be achieved by using amphiphilic polymers in aqueous environment, the latter is difficult to be prepared. The release patterns of the two groups are significantly different. The release of drugs from Group A microspheres is rather sequential, whereas group B microspheres release drugs in a parallel (co-release) manner. Nevertheless, in both groups, we found that the release of drugs can be easily tailored by altering outer/inner flow ratios. These findings present the advantages and possible application of this multi-drug release system in chemotherapy. Moreover, cell culture experiments have been performed to testify the performances of different microspheres in cytotoxicity and cellular apoptosis in vitro.

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Section: Introductionmentioning

confidence: 99%

Core/shell microspheres via coaxial electrohydrodynamic atomization for sequential and parallel release of drugs

Nie

Zhou

Arifin

et al. 2010

J Biomedical Materials Res

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“…For example, when inulin, a large molecule that has less potential to cross the blood–brain barrier, is administered by wafer technology, the inulin persists in the brain for a longer period of time and diffuses a larger distance from the brain/polymer interface. The feasibility of polifeprosan 20 polymer as a slow release delivery technology for alternative therapeutic agents has been demonstrated in preclinical models using paclitaxel,60 IUDR,61,62 temozolomide,63 taxotere64 camptothecin,65,66 tiripazamine,67 and other agents. When more effective agents are identified, this may be considered again.…”

Section: Wafer Technology: Possible Renewed Interest In the Future?mentioning

confidence: 99%

Polifeprosan 20, 3.85% carmustine slow release wafer in malignant glioma: patient selection and perspectives on a low-burden therapy

Kleinberg¹

2016

PPA

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Polifeprosan 20 with carmustine (GLIADEL®) polymer implant wafer is a biodegradable compound containing 3.85% carmustine (BCNU, bischloroethylnitrosourea) implanted in the brain at the time of planned tumor surgery, which then slowly degrades to release the BCNU chemotherapy directly into the brain thereby bypassing the blood–brain barrier. Carmustine implant wafers were demonstrated to improve survival in randomized placebo-controlled trials in patients undergoing a near total resection of newly diagnosed or recurrent malignant glioma. Based on these trials and other supporting data, carmustine wafer therapy was approved for use for newly diagnosed and recurrent malignant glioma in the United States and the European Union. Adverse events are uncommon, and as this therapy is placed at the time of surgery, it does not add to patient treatment burden. Nevertheless, this therapy appears to be underutilized. This article reviews the evidence for a favorable therapeutic ratio for the patient and the potential barriers. Consideration of these issues is important for optimal use of this therapeutic approach and may be important as this technology and other local therapies are further developed in the future.

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“…In addition, various chemotherapeutic agents other than BCNU have been exploited to deliver through polymeric system. Preclinical studies demonstrated that many drugs such as temozolomide, paclitaxel, taxotere, and camptothecin were efficacious against gliomas through polymeric delivery (46)(47)(48)(49). Further clinical investigation of the safety and efficacy is therefore warranted.…”

Section: Economic Considerationmentioning

confidence: 99%

Interstitial Chemotherapy for Malignant Gliomas

Sai¹,

Sun²,

Chen³

2016

Neurooncology - Newer Developments

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Glioma is the most common primary tumor in the central nervous system (CNS). Even with aggressive treatments, gliomas remain as one of the most devastating tumors. Chemotherapy through oral administration of temozolomide (TMZ) is currently the standard regimen for malignant gliomas. However, the systemic toxicity and drug resistance are frequently observed in glioma patients. In order to improve the efficacy and minimize side effects, multiple strategies have been developed. Interstitial chemotherapy is a promising one. By directly delivering chemotherapeutic agents in tumor bed, interstitial chemotherapy bypasses the blood-brain barrier (BBB) and therefore achieves a higher concentration with less systemic exposure. In this chapter, we will have a thorough review on the development and the application of interstitial chemotherapy in gliomas, with the focus on the biomaterial-based and convection-enhanced delivery system. In addition, the future of interstitial chemotherapy is also be shortly discussed.Keywords: malignant gliomas, local therapy, surgery, adjuvant chemotherapy, temozolomide, Gliadel waffer IntroductionMalignant gliomas account for more than 50% of primary central nervous system (CNS) tumors and are among the most formidable cancers in human beings (1). Although aggressive debulking surgery followed by radiation and chemotherapy is the mainstay for malignant gliomas, the prognosis of malignant gliomas remains far from satisfactory. The 5-year overall survival (OS) is as low as 9.8% for patients with glioblastoma multiforme (GBM), a malignancy classified as grade IV by the world health organization (WHO) (2). The recurrence seems to be inevitable for malignant gliomas. Most patients with recurred GBM will die within 6 months even with salvage treatments.© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.The exact mechanisms underlying the intractability of malignant gliomas have not been fully understood, but the inherent resistance and the sheltering environment of brain have been proposed to protect the disease from conventional treatments. First of all, the infiltrative growth pattern of glioma cells makes the complete surgical resection almost impossible. Second, the existence of blood-brain barrier (BBB), which is tightly formed by capillary endothelial cells together with astrocytes, restricts the entry of most systemically administered chemotherapeutic agents into the tumor parenchyma (3). Third, the inherent and acquired insensitivity to radiation and chemotherapy through the disturbance of signaling pathway in glioma cells results in the resistance to current therapies (4). Because gliomas seldom metastasize outside the CNS and usually recur within 1-2 cm from the original tumor site, it is reasonable to expect the efficacy of directly deliv...

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Interstitial Docetaxel (Taxotere), Carmustine and Combined Interstitial Therapy: a Novel Treatment for Experimental Malignant Glioma

Cited by 32 publications

References 36 publications

Core/shell microspheres via coaxial electrohydrodynamic atomization for sequential and parallel release of drugs

Core/shell microspheres via coaxial electrohydrodynamic atomization for sequential and parallel release of drugs

Polifeprosan 20, 3.85% carmustine slow release wafer in malignant glioma: patient selection and perspectives on a low-burden therapy

Interstitial Chemotherapy for Malignant Gliomas

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