International Journal of Nanomedicine (Jul 2021)
Role of Polymeric Local Drug Delivery in Multimodal Treatment of Malignant Glioma: A Review
Abstract
Yuan-Yun Tseng,1 Tai-Yuan Chen,2 Shih-Jung Liu3,4 1Department of Neurosurgery, New Taipei Municipal Tu-Cheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City, Taiwan; 2Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; 3Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan; 4Department of Orthopedic Surgery, Chang Gung Memorial Hospital-Linkuo, Tao-Yuan, TaiwanCorrespondence: Shih-Jung LiuBiomaterials Lab, Mechanical Engineering, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 33302, TaiwanTel +886-3-2118611Fax +886-3-2118558Email [email protected]: Malignant gliomas (MGs) are the most common and devastating primary brain tumor. At present, surgical interventions, radiotherapy, and chemotherapy are only marginally effective in prolonging the life expectancy of patients with MGs. Inherent heterogeneity, aggressive invasion and infiltration, intact physical barriers, and the numerous mechanisms underlying chemotherapy and radiotherapy resistance contribute to the poor prognosis for patients with MGs. Various studies have investigated methods to overcome these obstacles in MG treatment. In this review, we address difficulties in MG treatment and focus on promising polymeric local drug delivery systems. In contrast to most local delivery systems, which are directly implanted into the residual cavity after intratumoral injection or the surgical removal of a tumor, some rapidly developing and promising nanotechnological methods—including surface-decorated nanoparticles, magnetic nanoparticles, and focused ultrasound assist transport—are administered through (systemic) intravascular injection. We also discuss further synergistic and multimodal strategies for heightening therapeutic efficacy. Finally, we outline the challenges and therapeutic potential of these polymeric drug delivery systems.Keywords: malignant glioma, chemoresistance, local delivery, nanofiber, nanoparticle, focused ultrasound, magnetic nanoparticles