Abstract:
INTRODUCTION:Medical treatment of brain metastases (BM) is still a controversial issue in cancer therapy being mainly limited by the existence of the BBB. Temozolomide (TMZ) can cross BBB and several clinical trials have been performed attempting to demonstrate the activity of TMZ in combination with whole brain radiotherapy (WBRT) in the treatment of BM. AREAS COVERED:This review summarizes TMZ-WBRT combination trials highlighting the confounding factors that limit the interpretation of the achieved results and describes the main clinical trials using TMZ in combination with other cytotoxic or biological agents. The main limitations of these trials are: i) patient selection for heterogenous primitive neoplasms and for heterogeneous neuro-functional score; ii) poor penetration across BBB of the other drugs; iii) cumulative toxicity and iv) poor control of extracranial tumor sites. EXPERT OPINION:Biotechnological, biological and biochemical advances in the management of BM could allow in short time the definition of new schedules based on the rational use of new anticancer weapons. The latter could be cytotoxic agents encapsulated in nanotechnological tools able to cross BBB, lipophilic small kinase inhibitors (lapatinib, sunitinib), mTOR inhibitors and PARP inhibitors combined with old drugs such as TMZ.
journal_name
Expert Opin Investig Drugsjournal_title
Expert opinion on investigational drugsauthors
Addeo R,Caraglia Mdoi
10.1517/13543784.2011.580736subject
Has Abstractpub_date
2011-07-01 00:00:00pages
881-95issue
7eissn
1354-3784issn
1744-7658journal_volume
20pub_type
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journal_title:Expert opinion on investigational drugs
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journal_title:Expert opinion on investigational drugs
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