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Updated: Apr 16, 2026
Delivery of Antibodies into the Murine Brain via Convection-enhanced Delivery
Published on: July 18, 2019
Convection-enhanced delivery for the treatment of glioblastoma
Michael A Vogelbaum1, Manish K Aghi1
1Brain Tumor & Neuro-Oncology Center and Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio (M.A.V.); Department of Neurological Surgery, University of California, San Francisco, California (M.K.A.).
Abstract:
Effective treatment of glioblastoma (GBM) remains a formidable challenge. Survival rates remain poor despite decades of clinical trials of conventional and novel, biologically targeted therapeutics. There is considerable evidence that most of these therapeutics do not reach their targets in the brain when administered via conventional routes (intravenous or oral). Hence, direct delivery of therapeutics to the brain and to brain tumors is an active area of investigation. One of these techniques, convection-enhanced delivery (CED), involves the implantation of catheters through which conventional and novel therapeutic formulations can be delivered using continuous, low-positive-pressure bulk flow. Investigation in preclinical and clinical settings has demonstrated that CED can produce effective delivery of therapeutics to substantial volumes of brain and brain tumor. However, limitations in catheter technology and imaging of delivery have prevented this technique from being reliable and reproducible, and the only completed phase III study in GBM did not show a survival benefit for patients treated with an investigational therapeutic delivered via CED. Further development of CED is ongoing, with novel catheter designs and imaging approaches that may allow CED to become a more effective therapeutic delivery technique.
Insights
Directly delivering glioblastoma (GBM) treatments to the brain via convection-enhanced delivery (CED) shows promise but faces challenges. Ongoing innovations in catheter and imaging technology aim to improve CED
Area of Science:
- Neuro-oncology
- Neurosurgery
- Drug Delivery Systems
Background:
- Glioblastoma (GBM) treatment remains challenging, with poor survival rates.
- Conventional drug delivery routes often fail to reach brain targets effectively.
- Direct brain and brain tumor therapeutic delivery is crucial for improved outcomes.
Purpose of the Study:
- To review the potential and limitations of convection-enhanced delivery (CED) for glioblastoma treatment.
- To highlight advancements in CED technology for direct therapeutic administration.
- To assess the current status and future directions of CED in neuro-oncology.
Main Methods:
- Review of preclinical and clinical investigations of convection-enhanced delivery (CED).
- Analysis of challenges related to catheter technology and delivery imaging in CED.
- Examination of the outcomes of a Phase III clinical trial involving CED for GBM.
Main Results:
- CED facilitates effective delivery of therapeutics to large brain and tumor volumes.
- Limitations in current catheter technology and imaging hinder CED reliability and reproducibility.
- A completed Phase III GBM study using CED did not demonstrate a survival benefit.
Conclusions:
- Convection-enhanced delivery (CED) offers a promising approach for direct glioblastoma treatment.
- Technological advancements in catheters and imaging are essential for improving CED efficacy.
- Further development is needed to overcome current limitations and realize the full potential of CED for GBM therapy.
