Abstract
Convection enhanced delivery is an effective alternative to routine delivery methods to overcome the blood brain barrier. However, its treatment efficacy remains disappointing in clinic owing to the rapid drug elimination in tumour tissue. In this study, multiphysics modelling is employed to investigate the combination delivery of anti-angiogenic and cytotoxic drugs from the perspective of intratumoural transport. Simulations are based on a 3-D realistic brain tumour model that is reconstructed from patient magnetic resonance images. The tumour microvasculature is targeted by bevacizumab, and six cytotoxic drugs are included, as doxorubicin, carmustine, cisplatin, fluorouracil, methotrexate and paclitaxel. The treatment efficacy is evaluated in terms of the distribution volume where the drug concentration is above the corresponding LD90. Results demonstrate that the infusion of bevacizumab can slightly improve interstitial fluid flow, but is significantly efficient in reducing the fluid loss from the blood circulatory system to inhibit the concentration dilution. As the transport of bevacizumab is dominated by convection, its spatial distribution and anti-angiogenic effectiveness present high sensitivity to the directional interstitial fluid flow. Infusing bevacizumab could enhance the delivery outcomes of all the six drugs, however, the degree of enhancement differs. The delivery of doxorubicin can be improved most, whereas, the impacts on methotrexate and paclitaxel are limited. Fluorouracil could cover the comparable distribution volume as paclitaxel in the combination therapy for effective cell killing. Results obtain in this study could be a guide for the design of this co-delivery treatment.
Original language | English |
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Article number | 105094 |
Number of pages | 12 |
Journal | European Journal of Pharmaceutical Sciences |
Volume | 141 |
Early online date | 15 Oct 2019 |
DOIs | |
Publication status | Published - 1 Jan 2020 |
Keywords
- anti-angiogenesis
- brain tumour
- convection enhanced delivery
- drug transport
- mathematical modelling
- Drug transport
- Brain tumour
- DRUG-DELIVERY
- BEVACIZUMAB
- METHOTREXATE
- METASTATIC COLORECTAL-CANCER
- Convection enhanced delivery
- MALIGNANT GLIOMA
- PHASE-II TRIAL
- IN-VITRO
- TRANSPORT
- PHARMACOKINETICS
- Mathematical modelling
- Anti-angiogenesis
- HIGH-GRADE GLIOMA