Convection-enhanced Delivery in Glioblastoma: A Review of Preclinical and Clinical Studies

J Neurosurg. 2017 Jan;126(1):191-200. doi: 10.3171/2016.1.JNS151591. Epub 2016 Apr 1.

Abstract

Glioblastoma is the most common malignant brain tumor, and it carries an extremely poor prognosis. Attempts to develop targeted therapies have been hindered because the blood-brain barrier prevents many drugs from reaching tumors cells. Furthermore, systemic toxicity of drugs often limits their therapeutic potential. A number of alternative methods of delivery have been developed, one of which is convection-enhanced delivery (CED), the focus of this review. The authors describe CED as a therapeutic measure and review preclinical studies and the most prominent clinical trials of CED in the treatment of glioblastoma. The utilization of this technique for the delivery of a variety of agents is covered, and its shortcomings and challenges are discussed in detail.

Keywords: BBB = blood-brain barrier; CED = convection-enhanced delivery; GDL = gadoteridol-loaded liposomes; HSV-TK = herpes simplex virus–thymidine kinase; IL-4 = interleukin-4; OS = overall survival; PFS = progression-free survival; TF = transferrin; TMZ = temozolomide; TRAIL = tumor necrosis factor–related apoptosis-inducing ligand; blood-brain barrier; convection enhanced delivery; glioblastoma; oncology.

Publication types

  • Review

MeSH terms

  • Animals
  • Brain Neoplasms / drug therapy*
  • Convection
  • Drug Delivery Systems / methods*
  • Glioblastoma / drug therapy*
  • Humans