Neurooncology anticancer drugs are no exception—their distribution and tissue interactions follow the general rules of classical pharmacology. In an attempt to assist with the new therapeutic approaches to manage cancers involving the central nervous system, classical chemobiodynamic compartment and pharmacokinetic models are discussed and illustrated. In addition, strategies and approaches for penetrating the blood brain barrier (BBB) are reviewed and modeled. Finally, in support of classical pharmacology, a new anticancer agent in clinical trial for brain tumors is reviewed as an example of clinical onco-neuropharmacology.
Part of the book: New Approaches to the Management of Primary and Secondary CNS Tumors
The blood-brain barrier (BBB) is a highly selective semi-permeable membrane that separates the cerebral blood circulation from the brain and extracellular fluid in the central nervous system (CNS). The BBB is composed of endothelial cells, astrocyte end-feet and pericytes embedded in the capillary basement membrane. This system allows the passage of water, some gases and lipid-soluble molecules by passive diffusion, as well as, selective molecules such as glucose and amino acids. This review discusses pharmacodynamic concepts and methods that allow drugs to penetrate the BBB structure and enter the CNS and spinal nervous systems (SNS).
Part of the book: Brain and Spinal Tumors