Malignant gliomas are among the most devastating human cancers. The infiltrating nature of these malignancies makes complete surgical resection nearly impossible. Conventional therapy for malignant gliomas consists primarily of surgical debulking followed by radiation therapy and possibly chemotherapy. The major factor limiting intracranial therapeutic levels of systemically administered chemotherapeutics is the physiologic barriers of the brain. This has led to the development of novel methods of drug delivery such as implantable polymers containing chemotherapeutic agents. Several phase III clinical trials show that implantation of carmustine-containing biodegradable polymers prolongs survival in patients with both recurrent and newly diagnosed malignant gliomas. In this article, we summarize these trials and discuss ongoing clinical trials involving implantable chemotherapy-containing polymers in the treatment of patients with malignant gliomas.
Under a licensing agreement between Guilford Pharmaceuticals Inc. and the Johns Hopkins University, Dr. Henry Brem is entitled to a share of the royalties received by the University on sales of products described in this work. Dr. Brem and the University own Guilford Pharmaceuticals Inc. stock, which is subject to certain restrictions under University policy. Dr. Brem is also a paid consultant to Guilford Pharmaceuticals Inc. The terms of this arrangement are being managed by the Johns Hopkins University in accordance with its conflict of interest policies.