Imaging-guided convection-enhanced delivery and gene therapy of glioblastoma.

Abstract:

:In a prospective phase I/II clinical study, we treated eight patients suffering from recurrent glioblastoma multiform with stereotactically guided intratumoral convection-enhanced delivery of an HSV-1-tk gene-bearing liposomal vector and systemic ganciclovir. Noninvasive identification of target tissue together with assessment of vector-distribution volume and the effects of gene therapy were achieved using magnetic resonance imaging and positron emission tomography. The treatment was tolerated well without major side effects. In two of eight patients, we observed a greater than 50% reduction of tumor volume and in six of eight patients focal treatment effects. Intracerebral infusion of contrast medium before vector application displayed substantial inhomogeneity of tissue staining indicating the need of test infusions to monitor the mechanical distribution of vectors. Visualization of therapeutic effects on tumor metabolism and documentation of gene expression using positron emission tomography indicated that molecular imaging technology appears to be essential for the further development of biological treatment strategies.

journal_name

Ann Neurol

journal_title

Annals of neurology

authors

Voges J,Reszka R,Gossmann A,Dittmar C,Richter R,Garlip G,Kracht L,Coenen HH,Sturm V,Wienhard K,Heiss WD,Jacobs AH

doi

10.1002/ana.10688

keywords:

subject

Has Abstract

pub_date

2003-10-01 00:00:00

pages

479-87

issue

4

eissn

0364-5134

issn

1531-8249

journal_volume

54

pub_type

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