Abstract
While chemotherapy can definitely prolong survival of patients with glioblastomas, this tumor remains incurable (1). It has generally been assumed that drugs that do not readily cross the normal blood-brain barrier would be unlikely to be effective against glioblastomas. While the blood-brain barrier is frequently disrupted in brain tumors, animal studies suggest that the disruption may be variable from one part of a tumor to another (2). In addition, actively growing tumor cells may penetrate into the area of the brain surrounding the tumor where the blood-brain barrier may be less disrupted than it is within the tumor itself (3). However, a number of pharmacological studies have indicated that potentially cytotoxic concentrations of different antineoplastic agents are frequently achieved within human intracerebral tumors even ifthe antineoplastic agent does not penetrate well into the normal central nervous system, and drug concentrations attainable in human brain tumors appear to generally be quite comparable to those achieved in extracerebral tumors (4–18). In addition, it is frequent to find moderative1y high concentrations of drug in brain for at least several millimetres beyond the grossly visible border of the tumor (5–7, 9–11, 14–17). Hence, while it might be necessary to use drugs that penetrate well into the normal central nervous system to cure glioblastomas, palliation should be possible with drugs that do not cross the normal blood-brain barrier, provided the drug is cytotoxic to glioblastoma cells. Thus, it would be reasonable to conduct studies of any new antineoplastic agent in patients with glioblastomas whether or not the drug does cross the intact blood-brain barrier.
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References
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Stewart, D.J. (1987). Preliminary Experience With Menogaril in the Treatment of Recurrent Glioblastomas. In: Chatel, M., Darcel, F., Pecker, J. (eds) Brain Oncology Biology, diagnosis and therapy. Developments in Oncology, vol 52. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-3347-7_77
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DOI: https://doi.org/10.1007/978-94-009-3347-7_77
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