Current Indications for Intraarterial Chemotherapy in Neurointerventional Surgery

In pursuit of a cure for cancer, it is imperative to utilize every tool, resource, and strategy. Included under this umbrella is the optimization of drug delivery. Broadly speaking, anti-cancer treatment has been perpetually hindered by off-target activity, systemic toxicity, and other adverse reactions. Intraarterial (IA) delivery of therapeutics is an approach that has garnered increased attention in recent years. This approach can deliver drug directly to the desired site with the potential to minimize systemic toxicity.

In this review, we briefly cover existing IA indications for peripheral solid tumors as a base from which we can learn, followed by trials and procedural considerations of IA drug delivery for neck, head, and central nervous system tumors.

While the bulk of IA research and clinical trials have focused on drug delivery outside of the central nervous system, there have been recent encouraging results in IA tumor treatment within the neurointerventional arena, such as head and neck tumors, retinoblastoma, glioblastoma multiforme, and central nervous system lymphoma.

This review highlights the need for increased clinical research on IA chemotherapeutic delivery as a multi-disciplinary approach involving neurointerventional surgeons.