Skip Navigation LinksHome > December 2011 - Volume 69 - Issue 6 > Regression of Recurrent Malignant Gliomas With Convection-En...
doi: 10.1227/NEU.0b013e3182233e24
Research-Human-Clinical Trials

Regression of Recurrent Malignant Gliomas With Convection-Enhanced Delivery of Topotecan

Bruce, Jeffrey N. MD*; Fine, Robert L. MD; Canoll, Peter MD, PhD§; Yun, Jonathan MD*; Kennedy, Benjamin C. MD*; Rosenfeld, Steven S. MD, PhD; Sands, Stephen A. PsyD; Surapaneni, Krishna MD**; Lai, Rose MD; Yanes, Candix L. RN*; Bagiella, Emilia PhD#; DeLaPaz, Robert L. MD**

Collapse Box


BACKGROUND: Convection-enhanced delivery of chemotherapeutics for the treatment of malignant glioma is a technique that delivers drugs directly into a tumor and the surrounding interstitium through continuous, low-grade positive-pressure infusion. This allows high local concentrations of drug while overcoming the limitations imposed by toxicity and the blood-brain barrier in systemic therapies that prevent the use of many potentially effective drugs.

OBJECTIVE: To examine the safety profile of a conventional chemotherapeutic agent, topotecan, via convection-enhanced delivery in the treatment of recurrent malignant gliomas and secondarily to assess radiographic response and survival.

METHODS: We performed a prospective, dose-escalation phase Ib study of the topoisomerase-I inhibitor topotecan given by convection-enhanced delivery in patients with recurrent malignant gliomas.

RESULTS: Significant antitumor activity as described by radiographic changes and prolonged overall survival with minimal drug-associated toxicity was demonstrated. A maximum tolerated dose was established for future phase II studies.

CONCLUSION: Topotecan by convection-enhanced delivery has significant antitumor activity at concentrations that are nontoxic to normal brain. The potential for use of this therapy as a generally effective treatment option for malignant gliomas will be tested in subsequent phase II and III trials.

Copyright © by the Congress of Neurological Surgeons


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.