Interstitial Chemotherapy and Polymer Drug Delivery

Malignant gliomas are among the most aggressive, rapidly progressive, and lethal tumors. Their historically poor prognosis has improved with research-driven advancements using intraoperative imaging and targeted therapeutics. However, recurrence remains a difficult challenge, underscoring both the limitations of surgery, and the need for a creative, multimodal approach in targeting these locally invasive neoplasms. Unique physiological barriers of the central nervous system that normally protect the brain from foreign substances present complex challenges that limit the delivery and efficacy of conventionally delivered chemotherapeutics. To bypass these barriers and limit harmful systemic toxicities, local polymer-based delivery strategies have been developed and continue to be improved. In this chapter, we examine the details of malignant glioma in order to review the history and rationale that supports different polymer-based systems of interstitial chemotherapeutic delivery. Finally, we explore the future role these drug delivery systems will play as they are used in conjunction with developing modalities such as immunotherapy and personalized medicine to advance the care and prognosis of patients with brain malignancies.