Cancers, Vol. 11, Pages 824: Improving the Brain Delivery of Chemotherapeutic Drugs in Childhood Brain Tumors

Cancers, Vol. 11, Pages 824: Improving the Brain Delivery of Chemotherapeutic Drugs in Childhood Brain Tumors Cancers doi: 10.3390/cancers11060824 Authors: Triarico Maurizi Mastrangelo Attinà Capozza Ruggiero The central nervous system (CNS) may be considered as a sanctuary site, protected from systemic chemotherapy by the meninges, the cerebrospinal fluid (CSF) and the blood-brain barrier (BBB). Consequently, parenchymal and CSF exposure of most antineoplastic agents following intravenous (IV) administration is lower than systemic exposure. In this review, we describe the different strategies developed to improve delivery of antineoplastic agents into the brain in primary and metastatic CNS tumors. We observed that several methods, such as BBB disruption (BBBD), intra-arterial (IA) and intracavitary chemotherapy, are not routinely used because of their invasiveness and potentially serious adverse effects. Conversely, intrathecal (IT) chemotherapy has been safely and widely practiced in the treatment of pediatric primary and metastatic tumors, replacing the neurotoxic cranial irradiation for the treatment of childhood lymphoma and acute lymphoblastic leukemia (ALL). IT chemotherapy may be achieved through lumbar puncture (LP) or across the Ommaya intraventricular reservoir, which are both described in this review. Additionally, we overviewed pharmacokinetics and toxic aspects of the main IT antineoplastic drugs employed for primary or metastatic child...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research