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Open AccessReview

Convection Enhanced Delivery for Diffuse Intrinsic Pontine Glioma: Review of a Single Institution Experience

by Umberto Tosi 1 and Mark Souweidane 1,2,*
1
Department of Neurological Surgery, Weill Cornell Medicine, New York, NY 10065, USA
2
Department of Neurological Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
*
Author to whom correspondence should be addressed.
Pharmaceutics 2020, 12(7), 660; https://doi.org/10.3390/pharmaceutics12070660
Received: 7 June 2020 / Revised: 11 July 2020 / Accepted: 13 July 2020 / Published: 14 July 2020
(This article belongs to the Special Issue Drug Delivery to Brain Tumors)
Diffuse intrinsic pontine gliomas (DIPGs) are a pontine subtype of diffuse midline gliomas (DMGs), primary central nervous system (CNS) tumors of childhood that carry a terrible prognosis. Because of the highly infiltrative growth pattern and the anatomical position, cytoreductive surgery is not an option. An initial response to radiation therapy is invariably followed by recurrence; mortality occurs approximately 11 months after diagnosis. The development of novel therapeutics with great preclinical promise has been hindered by the tightly regulated blood–brain barrier (BBB), which segregates the tumor comportment from the systemic circulation. One possible solution to this obstacle is the use of convection enhanced delivery (CED), a local delivery strategy that bypasses the BBB by direct infusion into the tumor through a small caliber cannula. We have recently shown CED to be safe in children with DIPG (NCT01502917). In this review, we discuss our experience with CED, its advantages, and technical advancements that are occurring in the field. We also highlight hurdles that will likely need to be overcome in demonstrating clinical benefit with this therapeutic strategy. View Full-Text
Keywords: convection enhanced delivery (CED); diffuse intrinsic pontine glioma (DIPG); diffuse midline glioma; clinical translation convection enhanced delivery (CED); diffuse intrinsic pontine glioma (DIPG); diffuse midline glioma; clinical translation
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Tosi, U.; Souweidane, M. Convection Enhanced Delivery for Diffuse Intrinsic Pontine Glioma: Review of a Single Institution Experience. Pharmaceutics 2020, 12, 660.

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