The advent of interstitial
chemotherapy has significantly increased therapeutic options for patients with
malignant glioma. Interstitial
chemotherapy can deliver high concentrations of chemotherapeutic agents, directly at the site of the
brain tumor while bypassing systemic toxicities.
Gliadel, a locally implanted
polymer that releases the
alkylating agent carmustine, given alone and in combination with various other antitumor and resistance modifying
therapies, has significantly increased the median survival for patients with
malignant glioma. Convection enhanced delivery, a technique used to directly infuse drugs into brain tissue, has shown promise for the delivery of
immunotoxins,
monoclonal antibodies, and chemotherapeutic agents. Preclinical studies include delivery of chemotherapeutic and
immunomodulating agents by
polymer and microchips. Interstitial
chemotherapy was shown to maximize local efficacy and is an important strategy for the efficacy of any multimodal approach.