Maximizing Function and Quality of Life of Patients with Glioblastoma after Surgical Resection: A Review of Current Literature

Smith-Cohn, Matthew; Chen, Zhijian; Peereboom, David M.; Stevens, Glen

doi:10.4236/jct.2016.712085

Cited by 6 publications

(2 citation statements)

References 197 publications

(164 reference statements)

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“…Limiting the opening of the BBB to a short period of time is another critical factor to consider. This barrier has been preserved and refined through millions of years of evolution which speaks to its physiologic importance [ 4 , 48 ]. To facilitate drug entry, the BBB must be open long enough for a significant amount of the therapeutic agent to access the CNS.…”

Section: Discussionmentioning

confidence: 99%

“…The adenosine receptor agonist regadenoson, which is FDA-approved for cardiac stress testing, was found to increase brain levels of the chemotherapy temozolomide in rats by 60% without an effect on plasma concentrations [ 15 ]. An appealing feature of regadenoson induced BBB disruption is its very temporary effect on the BBB, as the persistent opening of the BBB could lead to significant cerebral edema [ 4 , 15 , 48 ].…”

Section: Introductionmentioning

confidence: 99%

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Transient Opening of the Blood-Brain Barrier by Vasoactive Peptides to Increase CNS Drug Delivery: Reality Versus Wishful Thinking?

Smith-Cohn

Burley

Grossman

2022

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Background: The blood-brain barrier inhibits the central nervous system penetration of 98% of small molecule drugs and virtually all biologic agents, which has limited progress in the treatment of neurologic disease. Vasoactive peptides have been shown in animal studies to transiently disrupt the blood-brain barrier and regadenoson is currently being studied in humans to determine if it can improve drug delivery to the brain. However, there are many other vasoactive peptides that could potentially be used for this purpose. Methods: We performed a review of the literature evaluating the physiologic effects of vasoactive peptides on the vasculature of the brain and systemic organs. To assess the likelihood that a vasoactive peptide might transiently disrupt the blood-brain barrier, we devised a four-tier classification system to organize the evidence available. Results: We identified 33 vasoactive peptides with potential blood-brain barrier permeability-altering properties. To date, none of these are shown to open the blood-brain barrier in humans. 12 vasoactive peptides increased blood-brain barrier permeability in rodents. The remaining 23 had favorable physiologic effects on blood vessels but lacked specific information on permeability changes to the blood-brain barrier. Conclusion: Vasoactive peptides remain an understudied class of drugs with the potential to increase drug delivery and improve treatment in patients with brain tumors and other neurologic diseases. Dozens of vasoactive peptides have yet to be formally evaluated for this important clinical effect. This narrative review summarizes the available data on vasoactive peptides, highlighting agents that deserve further in vitro and in vivo investigations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transient Opening of the Blood-Brain Barrier by Vasoactive Peptides to Increase CNS Drug Delivery: Reality Versus Wishful Thinking?

Smith-Cohn

Burley

Grossman

2022

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Primary Neoplasms of the Brain in Adults

Smith-Cohn¹,

Gilbert²

2022

Holland‐Frei Cancer Medicine

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Overview In 2021, it is expected that at least 700,000 people in the United States will be living with a primary brain tumor. Primary brain tumors are a heterogeneous group of neoplasms arising from nervous system tissue and the surrounding meninges. Unique to these cancers is a presentation of neurologic symptoms such as seizures, worsened headaches, weakness, personality changes, impaired cognition, and speech difficulty. It is estimated that 70% of brain tumors are benign (most commonly meningiomas), while 30% are malignant (most commonly gliomas). Malignant brain tumors are among the most challenging cancers to treat, due to limited effective therapies and difficulty of drug delivery across the blood–brain barrier. Despite the challenges, there has been a tremendous amount of knowledge gained about these neoplasms over the past decade. The 2016 World Health Organization (WHO) classification of central nervous system tumors (CNS) introduced the integration of histologic evaluation and molecular alterations to make a more informed diagnosis of these alterations, which have prognostic implications. This article will review the most encountered primary brain neoplasms and their management approaches.

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Neuropsychological Assessment in Brain Tumor Patients

Rodríguez-Orozco

2020

Principles of Neuro-Oncology

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Maximizing Function and Quality of Life of Patients with Glioblastoma after Surgical Resection: A Review of Current Literature

Cited by 6 publications

References 197 publications

Transient Opening of the Blood-Brain Barrier by Vasoactive Peptides to Increase CNS Drug Delivery: Reality Versus Wishful Thinking?

Transient Opening of the Blood-Brain Barrier by Vasoactive Peptides to Increase CNS Drug Delivery: Reality Versus Wishful Thinking?

Primary Neoplasms of the Brain in Adults

Neuropsychological Assessment in Brain Tumor Patients

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