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Tumors of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Alternating electric field therapy has also been explored for treatment of high-grade gliomas. Optune is one such device, which generates alternating current using four pads applied to a patient's scalp, powered by a battery. The current is thought to interfere with mitotic spindle assembly and disrupt tumor cell division. Patients must maintain their heads shaved and have the device active at least 18 hours per day for efficacy. It is an FDA-approved treatment for glioblastoma, associated with a modest survival benefit in the newly diagnosed setting.
Electrochemical generation of microbubbles by carbon nanotube interdigital electrodes to increase the permeability and material uptakes of cancer cells
Published in Drug Delivery, 2019
Mohammad Ali Khayamian, Shahriar Shalileh, Shohreh Vanaei, Mohammad Salemizadeh Parizi, Saeid Ansaryan, Mohammad Saghafi, Fereshteh Abbasvandi, Amirali Ebadi, Pouya Soltan Khamsi, Mohammad Abdolahad
Cancer has gathered the scientists around the world for propounding an idea to harness one of the very mortal diseases of the current century. Chemotherapy or delivery of anticancer drugs to the tumorigenic tissue has been a conventional method of cancer therapy (Skeel & Khleif, 2011; Wagner et al., 2017), which has been always accompanied with some challenges such as chemo-resistance of the cancerous cells (Wang et al., 2010; Abdullah & Chow, 2013) and detrimental side effects of the designed drugs (Monsuez et al., 2010; Florea & Büsselberg, 2011). To reduce the side-effects, various drug delivery systems including photothermal therapy (Huang et al., 2006; Riley & Day, 2017), ultrasound-assisted chemotherapy (Couture et al., 2014; Mullick Chowdhury et al., 2017), alternating electric field therapy (Kim et al., 2016; Rick et al., 2018) etc. have been developed to stimulate the site of interest, which would subsequently enhance transport of chemotherapeutics to the malignant region with minimum damage to the other organs (Yao et al., 2016). Maximizing the drug uptake in targeted lesions along with minimizing the primary dose of drug not only would increase the treating efficacy but also would reduce the therapeutic side effects.
Combining locoregional CAR-T cells, autologous + allogeneic tumor lysate vaccination and levamisole in treatment of glioblastoma
Published in Immunopharmacology and Immunotoxicology, 2022
Meric A. Altinoz, Alp Ozpinar, Emily Hacker, Aysel Ozpinar
Malignant glial brain tumors including glioblastoma (GBM), are commonly encountered primary brain malignancies. GBM has the poorest prognosis with an average survival of 15 months after diagnosis [1]. Despite advances in conventional chemotherapy, angiogenesis inhibitors, and new modalities including alternating electric field therapy, there have been few significant improvements in patient survival in recent years [1,2]. Standard treatment for GBM patients with good performance is the Stupp protocol which includes gross-total safe surgical resection followed by radiotherapy with concurrent temozolomide chemotherapy and six cycles of postradiotherapy [3]. However, for patients with a new diagnosis of GBM, the median increase in survival for temozolomide treatment and radiotherapy is only 2.5 months in comparison to radiotherapy alone [4]. Moreover, temozolomide induces a hypermutational genotype in high grade glial tumors by inducing thousands of de novo coding mutations which may increase the aggressiveness of these neoplasias [5]. Progression free survival may be increased but not overall survival benefits were observed with angiogenesis inhibitors including bevacizumab [6,7]. In this context, development of innovative novel strategies for GBM patients is an urgent need. Immunotherapeutical strategies may be plausible options. Investigations of adoptive cell transfer and peptide vaccines in malignant glioma have revealed that systemically applied immune treatments can induce antigen-specific T lymphocyte responses [1]. To our view, robust immunotherapies activating several immune cascades simultaneously may pave the way for successful treatment of this grave malignancy. In this hypothetical study, we will propose a combinatory regimen including application of CAR-T cells, adoptive + allogeneic tumor lysate treatment and levamizole for treatment of human GBM. At first, we will describe the hurdles of successful immune treatment of GBMs. The potential synergistic interactions between CAR-T cells, autologous + allogeneic tumor lysate vaccination and levamisole is depicted in Figure 1. Table 1 demonstrates potential antigens which can be targeted in glioblastoma treatment and Table 2 shows potential advantages and disadvantages of the proposed triple treatment.