Innovative brain tumor therapy. Nanoparticle-based therapeutic strategies

Despite recent advances in surgery as well as radiotherapy and chemotherapy, therapeutic efforts have not successfully established a defi nitive strategy of effective treatments for brain gliomas. Overall mortality is still high with an average survival less than 1 year in cases of glioblastoma. The standard protocol includes maximal surgical resection with postoperative combination of radiotherapy with concomitant and adjuvant chemotherapy. This treatment has improved the median overall survival from 6 to 14.6 months. Notwithstanding, malignant brain tumors remain lethal. The presence of the blood–brain barrier selectively impedes the passage of numerous types of molecules inside the brain. This limits the effi cacy of current drugs. The understanding of epigenetic modifi cations during neural differentiation and an insight into oncogenesis processes will likely help in developing new epigenetic/genetic- based treatments acting upstream. These complex fi elds may reveal the most effective therapeutic modalities but need selective drug delivery systems to reach the tumor cells. Hence, the new frontier in reliable brain tumor therapy places it trust in nanoparticles. Their nanometric size, electrostatic charge, and lipophilic characteristics allow them to penetrate into the brain tissue freely. Nanotechnology could therefore be used both to improve treatment effi cacy and to reduce the adverse side effects. Nanotechnology- based approaches to targeted NOT FOR DISTRIBUTION xiv Innovative brain tumour therapy delivery of drugs across the blood–brain barrier may potentially be engineered to carry out specifi c functions as needed. Moreover, nanoparticles show tumor- specifi c targeting and long blood circulation times, with consequent low short- term toxicity. Promising in vitro results have been reported, but remain to be validated in humans. Nanomedicine, the application of nanotechnology to healthcare, holds great promise not only for revolutionizing medical treatments, but also in imaging for a faster diagnosis, and in tissue regeneration. This book focuses on the pathophysiology of the blood– brain barrier in brain tumors, and the possibilities of overcoming this with nanoparticle- based systems. It presents a synopsis of the latest studies on nanoparticles as ideal devices for brain tumor treatment. Relevant patents of nanoparticles used as drug delivery carriers are also reported, as well as future scenarios concerning nanoparticles and stem cells.