Intra-Arterial Drug Delivery for Central Nervous System Tumors

Intra-arterial drug delivery (IADD) represents a targeted therapeutic approach in which anticancer agents are administered directly into the arteries supplying central nervous system (CNS) tumours. By bypassing systemic circulation, IADD can achieve higher intratumoral drug concentrations while limiting off-target toxicity. The technique typically involves endovascular navigation of microcatheters into the internal carotid or vertebral arteries, often combined with transient blood–brain barrier (BBB) or blood–tumour barrier (BTB) disruption through hyperosmolar agents, pharmacological modulators or focused ultrasound. Clinical applications have centred on high-grade gliomas, metastatic lesions and certain paediatric tumours, where conventional treatments yield limited success. Emerging refinements include superselective catheterisation, real-time imaging guidance and the integration of nanocarrier systems or radiotherapeutic particles. While early-phase studies confirm the feasibility and preliminary safety of IADD, ongoing challenges remain in optimising dosing, minimising vascular complications and standardising protocols. As an interdisciplinary frontier between neurointerventional radiology and oncology, IADD holds promise for improving outcomes in CNS malignancies with historically poor prognoses.

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Intra-Arterial Drug Delivery for Central Nervous System Tumors publication trend

The graph below shows the total number of articles in intra-arterial drug delivery for central nervous system tumors across all publications each year (not limited to Nature Index journals).

Technical terms

Intra-arterial drug delivery (IADD): Administration of therapeutic agents directly into arteries feeding CNS tumours to increase local concentration and reduce systemic exposure.

Blood–brain barrier (BBB): A selective endothelial barrier that restricts passage of most drugs from the bloodstream into healthy brain tissue.

Blood–tumour barrier (BTB): A modified form of the BBB within tumour vasculature, often heterogeneous in permeability.

Superselective endovascular intervention: Precise catheter navigation into specific tumour-feeding arteries to enhance targeting accuracy.

Microbubble: Gas-filled biocompatible particle used as a carrier for drugs or radiotherapeutic isotopes in endovascular delivery.

Radioembolization: Technique of delivering radioactive microspheres via arterial infusion to irradiate tumours from within.

References

1. PVA-Microbubbles as a Radioembolization Platform: Formulation and the In Vitro Proof of Concept. Pharmaceutics (2023).
2. Strategies for Improved Intra-arterial Treatments Targeting Brain Tumors: a Systematic Review. Frontiers in Oncology (2020).
3. A systematic review on intra-arterial cerebral infusions of chemotherapeutics in the treatment of glioblastoma multiforme: The state-of-the-art. Frontiers in Oncology (2022).