In this episode of the Backtable Podcast, guest host Dr. Paul Bhogal, a consultant interventional neuroradiologist at Royal London Hospital in the UK, and guests Dr. Piotr Walczak and Dr. Prakash Ambady discuss the potential of intra-arterial treatments combined with blood brain barrier (BBB) manipulation in treating various neurological conditions and tumors.

The trio of doctors discuss methods such as the use of hyperosmolar mannitol and focused ultrasound to breach the BBB and deliver drugs directly to the brain tissue. Dr. Walczak and Dr. Ambady also highlight their individual research areas, including therapies involving cell delivery and engineered cells. The conversation also covers potential risks and new perspectives in comparison to current techniques such as whole-brain radiation.

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SHOW NOTES

00:00 - Introduction

05:44 - Challenges of Treating Glioblastoma Multiforme

12:52 - Understanding the Blood Brain Barrier

18:30 - Strategies to Negate the Blood Brain Barrier

20:52 - Blood Brain Barrier Disruption Using Intra-Arterial Mannitol

26:35 - Infusion Rates and Magnetic Resonance Guidance

33:47 - Role of Radiolabel Studies in Drug Delivery

36:31 - Future of Therapeutic Agents Design

47:54 - Potential of Focused Ultrasound in Drug Delivery

56:10 - Exploring the Use of Cells in Drug Delivery

58:44 - Future of Intra-Arterial Interventions

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RESOURCES

Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma:

https://pubmed.ncbi.nlm.nih.gov/15758009/

Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomized phase III study: 5-year analysis of the EORTC-NCIC trial:

https://pubmed.ncbi.nlm.nih.gov/19269895/

REMOVAL OF RIGHT CEREBRAL HEMISPHERE FOR CERTAIN TUMORS WITH HEMIPLEGIA - PRELIMINARY REPORT:

https://jamanetwork.com/journals/jama/article-abstract/254927

Real-Time MRI Guidance for Reproducible Hyperosmolar Opening of the Blood-Brain Barrier in Mice:

https://www.researchgate.net/publication/328537972_Real-Time_MRI_Guidance_for_Reproducible_Hyperosmolar_Opening_of_the_Blood-Brain_Barrier_in_Mice

Dr. Piotr Walczak ResearchGate Profile:

https://www.researchgate.net/profile/Piotr-Walczak-6

Dr. Prakash Ambday ResearchGate Profile:

https://www.researchgate.net/profile/Prakash-Ambady

Maculopathy Associated With Osmotic Blood- Brain Barrier Disruption and Chemotherapy in Patients With Primary CNS Lymphoma:

https://pubmed.ncbi.nlm.nih.gov/32484895/

PET imaging of intra-arterial 89 Zr bevacizumab in mice with and without osmotic opening of the blood-brain barrier: distinct advantage of intra-arterial delivery:

10.2967/jnumed.118.218792

Safety of intra-arterial chemotherapy with or without osmotic blood–brain barrier disruption for the treatment of patients with brain tumors:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307096/

Delivery of chemotherapeutics across the blood-brain barrier: challenges and advances:

https://pubmed.ncbi.nlm.nih.gov/25307218/