Abstract
Glioblastoma (GBM) is the most aggressive malignant brain tumor and is associated with a very poor prognosis. The standard treatment for newly diagnosed patients involves total tumor surgical resection (if possible), plus irradiation and adjuvant chemotherapy. Despite treatment, the prognosis is still poor, and the tumor often recurs within two centimeters of the original tumor. A promising approach to improving the efficacy of GBM therapeutics is to utilize biomaterials to deliver them locally at the tumor site. Local delivery to GBM offers several advantages over systemic administration, such as bypassing the blood-brain barrier and increasing the bioavailability of the therapeutic at the tumor site without causing systemic toxicity. Local delivery may also combat tumor recurrence by maintaining sufficient drug concentrations at and surrounding the original tumor area. Herein, we critically appraised the literature on local delivery systems based within the following categories: polymer-based implantable devices, polymeric injectable systems, and hydrogel drug delivery systems. We also discussed the negative effect of hypoxia on treatment strategies and how one might utilize local implantation of oxygen-generating biomaterials as an adjuvant to enhance current therapeutic strategies.
Highlights
Malignant brain tumors are one of the most lethal solid tumors leading to very poor prognoses.[1]
Doxorubicin was covalently bound to the oxidized starch which resulted in a decreased burst effect and prolonged doxorubicin release in comparison to the non-conjugated control
The cellular response of tumor cells to hypoxia depends on the expression of multiple genes that are mainly controlled by hypoxia-inducible transcription factors (HIFs)
Summary
Malignant brain tumors are one of the most lethal solid tumors leading to very poor prognoses.[1]. Primary and secondary GBMs create distinctive subtypes affecting patients of different ages and are formed by distinct genetic pathways and vary in the prognosis.[4] Primary GBM comprises 90% of the GBM cases, which usually affect elderly patients and have a worse prognosis than secondary GBM.[5] The global incidence rate of GBM is equal to 10 per 100 000 population every year,[6] with an average age of onset between 65 to 75 years.[7] Despite the combined regimen of surgery, radiotherapy, and systemic chemotherapy, the prognosis of GBM remains poor.[8] New therapeutics and new therapeutic strategies are needed to improve the outcome for patients To this end, in this review, we have focused on the potential emerging strategy of utilizing biomaterials for local delivery of chemotherapeutics or adjuvant treatments to malignant brain tumors
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