Strategies for Improved Intra-arterial Treatments Targeting Brain Tumors: a Systematic Review

Huang, Rui; Boltze, Johannes; Shen, Li

doi:10.3389/fonc.2020.01443

Cited by 28 publications

(32 citation statements)

References 227 publications

(194 reference statements)

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“…Moreover, in comparison to intravenous administration, intraarterial administration of the radiopharmaceutical led to an increased tumor uptake, as demonstrated in a recent study by Vonken et al, who evaluated patients with meningiomas refractory to surgery and radiotherapy [ 97 ]. Intraarterial administration of the radiopharmaceutical has been demonstrated to be useful in PBTs with other therapeutic agents such as chemotherapeutic drugs as well, increasing the intratumoral drug concentration [ 98 ]. Further studies are needed, but this approach may be useful and effective in meningiomas (and other PBTs) using radiolabeled somatostatin analogs.…”

Section: Discussionmentioning

confidence: 99%

Peptide Receptor Radionuclide Therapy and Primary Brain Tumors: An Overview

et al. 2021

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Primary brain tumors (PBTs) are some of the most difficult types of cancer to treat, and despite advancements in surgery, chemotherapy and radiotherapy, new strategies for the treatment of PBTs are needed, especially for those with poor prognosis such as inoperable/difficult-to-reach lesions or relapsing disease. In regard to the last point, malignant primary brain tumors remain some of the most lethal types of cancer. Nuclear medicine may provide exciting new weapons and significant contributions in the treatment of PBTs. In this review, we performed literature research in order to highlight the possible role of peptide receptor radionuclide therapy (PRRT) in the treatment of PBTs with radiolabeled molecules that bind with high-affinity transmembrane receptors such as somatostatin receptors (SSTRs), neurokinin type-1 receptor and prostate-specific membrane antigen (PSMA). These receptors are overexpressed in some cancer types such as gliomas, meningiomas, pituitary tumors and medulloblastomas. A comprehensive overview of possible applications in this field will be shown, providing knowledge about benefits, feasibility, developments and limitations of PRRT in this type of tumor, also revealing new advantages in the management of the disease.

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Section: Discussionmentioning

confidence: 99%

Peptide Receptor Radionuclide Therapy and Primary Brain Tumors: An Overview

et al. 2021

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“…This effectively bypasses the blood-brain barrier, overcomes interstitial hypertension, and reduces off-target effects, but increases risks of stroke, infection, and mass effect, as well as costs. Minimally invasive procedures, including local convection-enhanced delivery through a transcranial cannula 57 and regional intraarterial delivery via carotid or vertebral catheterization, 58 may be advantageous.…”

Section: Delivery Approachesmentioning

confidence: 99%

Synthetic and systems biology principles in the design of programmable oncolytic virus immunotherapies for glioblastoma

Monie

Bhandarkar

Parney

et al. 2021

Neurosurgical Focus

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Oncolytic viruses (OVs) are a class of immunotherapeutic agents with promising preclinical results for the treatment of glioblastoma (GBM) but have shown limited success in recent clinical trials. Advanced bioengineering principles from disciplines such as synthetic and systems biology are needed to overcome the current challenges faced in developing effective OV-based immunotherapies for GBMs, including off-target effects and poor clinical responses. Synthetic biology is an emerging field that focuses on the development of synthetic DNA constructs that encode networks of genes and proteins (synthetic genetic circuits) to perform novel functions, whereas systems biology is an analytical framework that enables the study of complex interactions between host pathways and these synthetic genetic circuits. In this review, the authors summarize synthetic and systems biology concepts for developing programmable, logic-based OVs to treat GBMs. Programmable OVs can increase selectivity for tumor cells and enhance the local immunological response using synthetic genetic circuits. The authors discuss key principles for developing programmable OV-based immunotherapies, including how to 1) select an appropriate chassis, a vector that carries a synthetic genetic circuit, and 2) design a synthetic genetic circuit that can be programmed to sense key signals in the GBM microenvironment and trigger release of a therapeutic payload. To illustrate these principles, some original laboratory data are included, highlighting the need for systems biology studies, as well as some preliminary network analyses in preparation for synthetic biology applications. Examples from the literature of state-of-the-art synthetic genetic circuits that can be packaged into leading candidate OV chassis are also surveyed and discussed.

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“…Intra-arterial injection into intracranial vessels is one such strategy, with the potential to increase drug responses to primary and metastatic brain tumors [21][22][23][24][25][26][27][28][29][30]. Intra-arterial infusion of anti-cancer therapies can be combined with concurrent administration of a variety of agents, including chemical reagents, penetration drug carriers, or microbubbles for focused ultrasound, to selectively open the BBB in areas of interest [17,25,31,32]. By accessing intracranial vessels through peripheral arteries and directly administering BBB-disrupting and therapeutic agents into the arterial supply to the brain, intra-arterial injection facilitates greatly improved local drug delivery, increased intra-tumoral concentration, and lowered systemic exposure [33][34][35][36][37].…”

Section: Introductionmentioning

confidence: 99%

“…Since it was first described more than half a century ago, there have been considerable efforts not only to explore the biological mechanisms behind intra-arterial therapy but also to evaluate its applicability to a wide range of diseases. To date, multiple research studies are quoted to have investigated intra-arterial drug administration, yet there has been little, if any, translational impact observed for brain tumors [31,34,[38][39][40][41][42][43]. Therefore, it is important to characterize how impactful the literature and previous clinical trials have been to predict where this drug delivery approach is heading.…”

Section: Introductionmentioning

confidence: 99%

Status Quo and Trends of Intra-Arterial Therapy for Brain Tumors: A Bibliometric and Clinical Trials Analysis

2021

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Intra-arterial drug delivery circumvents the first-pass effect and is believed to increase both efficacy and tolerability of primary and metastatic brain tumor therapy. The aim of this update is to report on pertinent articles and clinical trials to better understand the research landscape to date and future directions. Elsevier’s Scopus and ClinicalTrials.gov databases were reviewed in August 2021 for all possible articles and clinical trials of intra-arterial drug injection as a treatment strategy for brain tumors. Entries were screened against predefined selection criteria and various parameters were summarized. Twenty clinical trials and 271 articles satisfied all inclusion criteria. In terms of articles, 201 (74%) were primarily clinical and 70 (26%) were basic science, published in a total of 120 different journals. Median values were: publication year, 1986 (range, 1962–2021); citation count, 15 (range, 0–607); number of authors, 5 (range, 1–18). Pertaining to clinical trials, 9 (45%) were phase 1 trials, with median expected start and completion years in 2011 (range, 1998–2019) and 2022 (range, 2008–2025), respectively. Only one (5%) trial has reported results to date. Glioma was the most common tumor indication reported in both articles (68%) and trials (75%). There were 215 (79%) articles investigating chemotherapy, while 13 (65%) trials evaluated targeted therapy. Transient blood–brain barrier disruption was the commonest strategy for articles (27%) and trials (60%) to optimize intra-arterial therapy. Articles and trials predominately originated in the United States (50% and 90%, respectively). In this bibliometric and clinical trials analysis, we discuss the current state and trends of intra-arterial therapy for brain tumors. Most articles were clinical, and traditional anti-cancer agents and drug delivery strategies were commonly studied. This was reflected in clinical trials, of which only a single study had reported outcomes. We anticipate future efforts to involve novel therapeutic and procedural strategies based on recent advances in the field.

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Strategies for Improved Intra-arterial Treatments Targeting Brain Tumors: a Systematic Review

Cited by 28 publications

References 227 publications

Peptide Receptor Radionuclide Therapy and Primary Brain Tumors: An Overview

Peptide Receptor Radionuclide Therapy and Primary Brain Tumors: An Overview

Synthetic and systems biology principles in the design of programmable oncolytic virus immunotherapies for glioblastoma

Status Quo and Trends of Intra-Arterial Therapy for Brain Tumors: A Bibliometric and Clinical Trials Analysis

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