Chemotherapy drugs delivered orally or intravenously are of limited effectiveness and often cause undesirable side effects. As part of a first clinical trial, researchers have developed a promising new mode of administration.
American researchers have developed a pump capable of delivering drugs from chemotherapy directly into the brains of brain cancer patients.
If the administered topotecan is cytotoxic for cancer cells, it is often clinically ineffective. Indeed, the blood-brain barrier does not allow all molecules to penetrate in the brainincluding chemotherapy drugs for cancer of the brain. Administered orally or intravenously, these therapies only reach the brain at low concentrations.
« The concentration of drug that ends up in the brain with this technique is 1,000 times higher than that which can be obtained by conventional means », relate Jeffrey Bruce, Research Professor of Neurological Surgery and lead author of the study published in Lancet Oncology. « The pump can stay in place for a long time, so we can deliver higher doses of chemotherapy into the brain, without causing side effects. »
A first conclusive clinical trial
In an early-stage clinical trial, five patients with recurrent glioblastoma received a total of four infusions, with alternating pump on and pump off days. The treatment successfully reduced the number of proliferating tumor cells, without affecting healthy cells. The researchers report no serious adverse events related to the study treatment.
In addition, they believe that this new mode of administration could transform the management of patients with a brain cancer, whose prospects for survival remain very low. However, the number of people included remains very low and additional trials are needed in patients with tumors at an earlier stage and with different types of chemotherapy.