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Glioblastoma (GBM) is the most common and deadliest primary brain tumor in adults.1 Despite aggressive surgery, radiation, and chemotherapy, the survival of patients with GBM is poor, with a mean survival of only 14.6 months.1 Targeted agents and immunotherapies, which have transformed the treatment of other cancers, are proving to be ineffective against GBM.2 In addition to the molecular heterogeneity of these tumors, this therapeutic failure is due in part to the inability to deliver therapies to the tumor because of the blood–brain barrier (BBB) and the blood–tumor barrier (BTB).3 Endovascular superselective intra-arterial (ESIA) infusion offers a potential means to efficiently deliver a high concentration of therapeutics to brain tumors and disrupt the BTB/BBB, thereby addressing the delivery problem in the treatment of GBM.
Intra-arterial (IA) therapy has been successful in treating several cancers,4 but has had limited success in the treatment of GBM. However, with the advent of stem cell-based therapies for GBM whose effectiveness depends on IA delivery,5 and the emergence of novel microcatheters to treat cerebrovascular disease, IA delivery has re-emerged as a potential delivery strategy for infusion of agents directly into the …
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Contributors All authors contributed equally.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.