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

Item Type:Article
Title:Imaging-guided convection-enhanced delivery and gene therapy of glioblastoma
Creators Name:Voges, J. and Reszka, R. and Gossmann, A. and Dittmar, C. and Richter, R. and Garlip, G. and Kracht, L. and Coenen, H.H. and Sturm, V. and Wienhard, K. and Heiss, W.D. and Jacobs, A.H.
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 gancidovir. 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.
Keywords:Brain, Brain Mapping, Computer-Assisted Image Processing, Emission-Computed Tomography, Gadolinium DTPA, Ganciclovir, Gene Therapy, Genetic Vectors, Glioblastoma, Human Herpesvirus 1, Liposomes, Magnetic Resonance Imaging, Prospective Studies, Thymidine Kinase, Time Factors
Source:Annals of Neurology
ISSN:0364-5134
Publisher:Wiley (U.S.A.)
Volume:54
Number:4
Page Range:479-487
Date:October 2003
Official Publication:https://doi.org/10.1002/ana.10688
PubMed:View item in PubMed

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