Towards a New Dawn for Neuro-Oncology: Nanomedicine at the Service of Drug Delivery for Primary and Secondary Brain Tumours.
Authors: Khilar S, Dembinska-Kenner A, Hall H, Syrmos N, Ligarotti GKI, Plaha P, Apostolopoulos V, Chibbaro S, Barbagallo GMV, Ganau M
(1) Background/Objectives: Primary and secondary brain tumours often hold devastating prognoses and low survival rates despite the application of maximal neurosurgical resection, and state-of-the-art radiotherapy and chemotherapy. One limiting factor in their management is that several antineoplastic agents are unable to cross the blood-brain barrier (BBB) to reach the tumour microenvironment. Nanomedicine could hold the potential to become an effective means of drug delivery to overcome previous hurdles towards effective neuro-oncological treatments. (2) Methods: A scoping review following the PRISMA-ScR guidelines and checklist was conducted using key terms input into PubMed to find articles that reflect emerging trends in the utilisation of nanomedicine in drug delivery for primary and secondary brain tumours. (3) Results: The review highlights various strategies by which different nanoparticles can be exploited to bypass the BBB; we provide a synthesis of the literature on the ongoing contributions to therapeutic protocols based on chemotherapy, immunotherapy, focused ultrasound, radiotherapy/radiosurgery, and radio-immunotherapy. (4) Conclusions: The emerging trends summarised in this scoping review indicate encouraging advantageous properties of nanoparticles as potential effective drug delivery mechanisms; however, there are still nanotoxicity issues that largely remain to be addressed before the translation of these innovations from laboratory to clinical practice.
Introduction
Purpose
Drug delivery with BBB opening
Study Objective
To conduct a scoping review identifying emerging trends and strategies in the use of nanomedicine for drug delivery across the blood–brain barrier in primary and secondary brain tumours.
Disease model
Primary and secondary brain tumours (brain cancer)
Cargo name and characteristics
Nanoparticles (various compositions) used as drug-delivery vehicles; cargos include small-molecule chemotherapeutics and immunotherapeutic agents (used in chemotherapy, immunotherapy and radio-immunotherapy contexts)
Outcomes and Safety
Summary of Outcomes
Nanoparticle-based strategies facilitate crossing the blood–brain barrier to enhance delivery of chemotherapy, immunotherapy and radiotherapy agents to primary and secondary brain tumours, showing promising therapeutic potential; however, nanotoxicity remains a significant unresolved concern. The review does not report specific focused ultrasound parameter sets tested or identified as successful.
Safety-related matter
The review reports unresolved safety concerns, specifically nanotoxicity issues that need to be addressed before translating nanoparticle-based therapies into clinical practice.
Brain Region
Ultrasound Parameters
Focal Characteristics
Focal depth: None; Focal length: None; Aperture size: None
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