KEY TAKEAWAYS
- The review analyzes BBB opening techniques in brain tumor trials, assesses challenges, and suggests future research directions.
- The results showed FUS effectively disrupts the BBB, but further studies and long-term follow-up are needed.
Brain cancers, especially aggressive forms like glioblastoma multiforme (GBM), pose significant treatment challenges. The blood-brain barrier (BBB) often restricts drug delivery to tumour sites, limiting treatment effectiveness. Focused ultrasound (FUS), when combined with microbubbles, provides a non-invasive method to temporarily open the BBB, offering a potential avenue for improving drug delivery and therapeutic outcomes.
Honglin Zhu and the team aimed to examine clinical trials employing BBB opening techniques to optimize pharmacotherapy for brain tumours, evaluate existing challenges, and propose directions for future research.
A systematic search was conducted in PubMed and ClinicalTrials.gov databases up to November 2023 using the keywords “ultrasound” AND “brain tumor”. After screening titles and abstracts, followed by full-text reviews, 35 studies (11 published, 24 ongoing) met the inclusion criteria and were included in the final analysis.
The analysis primarily focused on glioma, including GBM and astrocytoma, with 1 study investigating brain metastasis from breast cancer. The findings indicated that FUS effectively opens the BBB and enhances drug uptake following sonication. However, research on FUS application in children remains limited, with only 3 ongoing trials and no published studies in this demographic.
The study concluded that FUS is a promising strategy for safe and precise BBB disruption, enabling targeted lesioning and improved drug delivery to brain tumour sites. However, more pharmacokinetic studies are needed to quantify drug uptake improvements, and long-term follow-up is essential to evaluate the clinical benefits of this approach.
Further research involving diverse populations and pathologies will provide a more comprehensive understanding of this treatment strategy.
Funding support was provided from the Children’s Cancer and Leukaemia Group (CCLGA 2022 25), Action Medical Research/LifeArc (GN3017), the Focused Ultrasound Foundation (FUS1050R1), and Abbie’s Army/Children’s Brain Tumor Drug Delivery Consortium (KCL/G12/22).
Source: https://link.springer.com/article/10.1007/s11060-024-04795-z
Zhu H, Allwin C, Bassous MG, et al. (2024). “Focused ultrasound-mediated enhancement of blood-brain barrier permeability for brain tumor treatment: a systematic review of clinical trials.” J Neurooncol. 2024. doi:10.1007/s11060-024-04795-z.
