One-Year Outcome of Multiple Blood–Brain Barrier Disruptions With Temozolomide for the Treatment of Glioblastoma

So Hee Park, Myung Ji Kim, Hyun Ho Jung, Won Seok Chang, Hyun Seok Choi, Itay Rachmilevitch, Eyal Zadicario, Jin Woo Chang

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32 Citations (Scopus)


Introduction: To overcome the blood–brain barrier (BBB) which interferes with the effect of chemotherapeutic agents, we performed multiple disruptions of BBB (BBBD) with magnetic resonance-guided focused ultrasound on patients with glioblastoma (GBM) during standard adjuvant temozolomide (TMZ) chemotherapy [clinical trial registration no.NCT03712293 (]. We report a 1-year follow-up result of BBBD with TMZ for GBM. Methods: From September 2018 to January 2019, six patients were enrolled (four men and two women, median age: 53 years, range: 50–67 years). Of the six patients, five underwent a total of six cycles of BBBD during standard TMZ adjuvant therapy. One patient underwent three cycles of BBBD but continued with TMZ chemotherapy. The 1-year follow-up results of these six patients were reviewed. Results: The mean follow-up duration was 15.17 ± 1.72 months. Two patients showed a recurrence of tumor at 11 and 16 months, respectively. One underwent surgery, and the other patient was restarted with TMZ chemotherapy due to the tumor location with a highly possibility of surgical complications. The survival rate up to 1 year was 100%, and the other four patients are on observation without recurrence. None of the six patients had immediate or delayed BBBD-related complications. Conclusion: Multiple BBBDs can be regarded as a safe procedure without long-term complications, and it seems to have some survival benefits. However, since TMZ partially crosses the BBB, a further extended study with large numbers would be needed to evaluate the benefits of BBBD resulting in an increase of TMZ concentration. This study opened a new therapeutic strategy for GBM by combining BBBD with a larger molecular agent.

Original languageEnglish
Article number1663
JournalFrontiers in Oncology
Publication statusPublished - 2020 Sept 10

Bibliographical note

Funding Information:
Funding. This study was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (Grant No. HI19C0060).

Publisher Copyright:
© Copyright © 2020 Park, Kim, Jung, Chang, Choi, Rachmilevitch, Zadicario and Chang.

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


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