Topics: Addressing molecular-level barriers to brain tumour treatment
Type: Briefing paper
Publication date: December 2024
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Authors
Asad Jamal, Alexandra Porter, James Choi, Francesco Antonio Aprile, Ferdinando Rodriguez y Baena, Amin Hajitou, Kevin O’Neill, Sophie Camp, Matthew Williams, Nelofer Syed, Elena Corujo-Simon, Isabella von Holstein, and Daniele Dini
Summary
This paper explores the opportunities and barriers to treat high-grade brain tumours such as gliobastoma. It serves as a platform to review current approaches for delivering drugs to brain tumours and to explore the role of molecular interactions between drug molecules and brain tissues. This briefing highlights the need to exploit molecular design to maximise the benefits of drug delivery, and identifies the challenges to meet clinical needs, recommending policies to overcome them.
Headlines
Issues
- High-grade brain tumours, such as glioblastoma, affect thousands of lives, leading to approximately 250,000 deaths per year worldwide and high socioeconomic costs.
- Current average survival time is less than two years from diagnosis, even with the best current treatments using surgery, radiotherapy and chemotherapy.
- A key difficulty in treating these tumours is delivering drug treatments to the brain reliably and precisely; the blood-brain barrier (BBB) allows only small molecules to passively diffuse from the blood to the brain, therefore around 95% of drugs cannot be delivered to brain tumours.
- Drug molecules have complex interactions with brain tissue due to their electric charge, size, and shape; the conditions of delivery (temperature, pressure, concentration) also play a role. The impact of these factors remains poorly understood.
Solutions
- A range of methods have been developed to bypass the BBB to deliver drugs to the brain, including using carrier molecules, ultrasound, intra-nasal and intra-arterial delivery.
- Surgical methods include robotic steerable needles, which deliver drugs directly to the tumour target (infusion-based flow) via a burr hole in the skull.
- The development of new technologies requires bringing together a broad range of interdisciplinary expertise, including molecular-level understanding of biochemistry, biomechanics, medical robotics, advanced computational models and clinical expertise.