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利用微泡增强聚焦超声实现脑肿瘤的受控药物递送

英文原题:Towards controlled drug delivery in brain tumors with microbubble-enhanced focused ultrasound.

PubMed 2021/11/18(内容时间) Adv Drug Deliv Rev Q1 · IF 21(JCR 2025)

研究概要

脑肿瘤是特别具有挑战性的恶性肿瘤,因为其位于人体结构和功能独特的部位——中枢神经系统(CNS)。

中文摘要

脑肿瘤是特别具有挑战性的恶性肿瘤,因为其位于人体结构和功能独特的部分——中枢神经系统(CNS)。CNS由独特的脑和血管细胞系统分隔和保护,这些细胞共同阻止大多数血液传播的治疗药物进入脑肿瘤微环境(TME)。近年来,通过微泡(MB)超声造影剂结合超声能量,在局部增加脑血管通透性和调节脑TME方面取得了巨大进展。正如我们在本综述中详细阐述的,这种物理方法可以有效地将多种抗癌药物,包括化疗药物、抗体和纳米颗粒药物偶联物,递送穿过一系列临床前脑肿瘤,包括高级别胶质瘤(胶质母细胞瘤)、弥漫性内生性桥脑胶质瘤和脑转移瘤。此外,最近的证据表明,这项技术可以促进新型免疫治疗药物的有效递送,包括免疫检查点抑制剂和CAR-T 细胞等。随着早期临床研究证明其安全性,以及多项I/II期试验正在测试临床前发现,这项技术正在朝着塑造原发性和转移性脑癌未来治疗的方向稳步迈进。通过详细阐述其关键组成部分,包括超声系统和MB技术,以及MB活动的闭环空间和时间控制方法,我们强调了如何调整这项技术以实现原发性脑恶性肿瘤和脑转移瘤的新的个性化治疗策略。

展开英文摘要原文

Brain tumors are particularly challenging malignancies, due to their location in a structurally and functionally distinct part of the human body - the central nervous system (CNS). The CNS is separated and protected by a unique system of brain and blood vessel cells which together prevent most bloodborne therapeutics from entering the brain tumor microenvironment (TME). Recently, great strides have been made through microbubble (MB) ultrasound contrast agents in conjunction with ultrasound energy to locally increase the permeability of brain vessels and modulate the brain TME. As we elaborate in this review, this physical method can effectively deliver a wide range of anticancer agents, including chemotherapeutics, antibodies, and nanoparticle drug conjugates across a range of preclinical brain tumors, including high grade glioma (glioblastoma), diffuse intrinsic pontine gliomas, and brain metastasis. Moreover, recent evidence suggests that this technology can promote the effective delivery of novel immunotherapeutic agents, including immune check-point inhibitors and chimeric antigen receptor T cells, among others. With early clinical studies demonstrating safety, and several Phase I/II trials testing the preclinical findings underway, this technology is making firm steps towards shaping the future treatments of primary and metastatic brain cancer. By elaborating on its key components, including ultrasound systems and MB technology, along with methods for closed-loop spatial and temporal control of MB activity, we highlight how this technology can be tuned to enable new, personalized treatment strategies for primary brain malignancies and brain metastases.

论文信息

作者
Schoen S Jr、Kilinc MS、Lee H、Guo Y、Degertekin FL、Woodworth GF、Arvanitis C
第一作者单位
Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA.United States
通讯作者单位
Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA; Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, USA. Electronic address: costas.arvanitis@gatech.edu.United States
文献类型
美国 NIH 资助研究 · 非美国政府资助研究 · 美国政府(非公共卫生署)资助研究 · 综述
期刊
Advanced drug delivery reviews2022 Jan
原文标识
PubMed 34801617 · DOI 10.1016/j.addr.2021.114043