Regression of Recurrent Malignant Gliomas With Convection-Enhanced Delivery of Topotecan

摘要: Convection-enhanced delivery of chemotherapeutics for the treatment malignant glioma is a technique that delivers drugs directly into tumor and surrounding interstitium through chronic, low grade positive-pressure infusion. This allows high local concentrations drug while overcoming limitations imposed by toxicity blood-brain barrier in systemic therapies prevent use many potentially effective drugs. To examine safety profile conventional chemotherapeutic agent, topotecan, via convection-enhanced recurrent gliomas and, secondarily, to assess radiographic response survival. We performed prospective, dose-escalation Phase Ib study topoisomerase-I inhibitor, given patients with gliomas. Significant anti-tumor activity as described changes prolonged overall survival minimal drug-associated was demonstrated. A maximum tolerated dose established future phase II studies. Topotecan has significant at are non-toxic normal brain. The potential this therapy generally option will be tested subsequent III trials.