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In what situations can a polymer wafer implant be used to deliver chemotherapy to a brain tumor?
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HenryFriedmanMD (Physician - Neuro-Oncology (Verified) ) - 07 / 03 / 2012
There is only one polymer wafer implant that has been approved for the treatment of patients with brain tumors. This is Gliadel which is the trade name for a wafer that releases BCNU into a tumor crater. It has been approved by the FDA for both newly diagnosed and recurrent malignant gloma and clearly produces a producible albeit modest increase in survival for these patients. Accordingly, there is a place for these wafers in the treatment of patients with these tumors.
Furthermore there are a number of clinical trials that are incorporating the use of Gliadel wafers into their therapeutic regimens. The role of Gliadel in these protocol settings is still being defined and represents a way to achieve concentrations of BCNU at the tumor site far higher than could be achieved if the drug was delivered by its traditional intravenous route of administration. To utilize these wafers, the tumor must be completely resected and not have a major connection to the ventricular system. Furthermore it should not be located near a very eloquent site since the local inflammation that is commonly seen following implantation of the wafers can produce significant morbidity. However if utilized in the appropriate setting, Gliadel wafers can increase survival and its role in future trials is still being investigated.
Furthermore there are a number of clinical trials that are incorporating the use of Gliadel wafers into their therapeutic regimens. The role of Gliadel in these protocol settings is still being defined and represents a way to achieve concentrations of BCNU at the tumor site far higher than could be achieved if the drug was delivered by its traditional intravenous route of administration. To utilize these wafers, the tumor must be completely resected and not have a major connection to the ventricular system. Furthermore it should not be located near a very eloquent site since the local inflammation that is commonly seen following implantation of the wafers can produce significant morbidity. However if utilized in the appropriate setting, Gliadel wafers can increase survival and its role in future trials is still being investigated.
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