Abstract
The current treatment for malignant brain tumors includes surgical resection, radiotherapy, and chemotherapy. Nevertheless, the survival rate for patients with glioblastoma multiforme (GBM) with a high grade of malignancy is less than one year. From a clinical point of view, effective treatment of GBM is limited by several challenges. First, the anatomical complexity of the brain influences the extent of resection because a fine balance must be struck between maximal removal of malignant tissue and minimal surgical risk. Second, the central nervous system has a distinct microenvironment that is protected by the blood–brain barrier, restricting systemically delivered drugs from accessing the brain. Additionally, GBM is characterized by high intra-tumor and inter-tumor heterogeneity at cellular and histological levels. This peculiarity of GBM-constituent tissues induces different responses to therapeutic agents, leading to failure of targeted therapies. Unlike surgical resection and radiotherapy, photodynamic therapy (PDT) can treat micro-invasive areas while protecting sensitive brain regions. PDT involves photoactivation of photosensitizers (PSs) that are selectively incorporated into tumor cells. Photo-irradiation activates the PS by transfer of energy, resulting in production of reactive oxygen species to induce cell death. Clinical outcomes of PDT-treated GBM can be advanced in terms of nanomedicine. This review discusses clinical PDT applications of nanomedicine for the treatment of GBM.
Highlights
As photodynamic therapy (PDT) has been developed since the 1980s, many other treatment options have been improved
The GQDs fabricated in the study were excited by visible light and showed photodynamic activity; their PDT effects were observed through apoptosis of Human cervical carcinoma cell lines (HeLa) cells and oncolysis of BALB/nude mice with breast cancer
This review presents examples of the improved overall effectiveness of PDT cancer treatment by demonstrating that NPs can provide a solution to the important limitations of traditional PS drug delivery
Summary
As photodynamic therapy (PDT) has been developed since the 1980s, many other treatment options have been improved. Additional studies are needed to enhance the targeting of brain tumors while considering the pharmacokinetic aspects and methods of improving the quantum yield of the PS, which generates effective reactive oxygen species under light irradiation In this regard, the rapidly developing fields of nanotechnology and nanomedicine are producing nanostructured materials that can overcome the shortcomings of delivery systems used in clinical practice. Many PS nanocarriers are still in the early stages of translation, many advances have been made in recent years for functional nanomedicines based on BBB crossing Another advantage of nanoparticles is that they can increase the low solubility of PS, prolong blood circulation, promote targeted delivery and cellular uptake, while protecting the drug from degradation. The possibility of application to brain tumors is discussed through clinical cases of nanomedicine-based PDT
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