Al's Comment:

 This is a different way to use Avastin: superselective intra-arterial cerebral infusion (SIACI) after Blood Brain Barrier Disruption.  The "standard" way involves IV infusion every other week until progression. This new way is delivering the Avastin only where it is needed by using a catheter inserted through the groin and threaded up to the area of the tumor. They can map out which arteries feed the tumor and inject the Avastin directly into those arteries in the brain, after blood brainso the drug is delivered in very high concentration exactly where it is needed, much higher dose to the tumor than using the IV methods. And the rest of the body doesn't get exposed, or gets a very insignificant dose, so it theoretically shouldn't have the systemic side effects of Avastin.  The procedure to perform this does add a risk, but it is only 3 injections, compared to many more the standard way.  

As to results, they look promising. The abstract did not include any controls so I looked up the original Avastin trial for newly diagnosed glioblastoma  using the standard IV method, and that did have a control group. This is just a rough comparison, as the results vary widely by many factors so the numbers aren't directly comparable.

Control group:  PFS: 7.3 months  Overall Survival:  16.1 months

IV Avastin : PFS: 10.7 months  Overall Survival:  15.7 months

SIACI Avastin:  PFS: 11.5 months  Overall Survival:  23.1 months

This is a proof of concept.  I would love to see this method of delivery used with a customized set of drugs based on the molecular pathology report from the surgery. 

Posted on: 10/04/2021


Repeated superselective intraarterial bevacizumab after blood brain barrier disruption for newly diagnosed glioblastoma: a phase I/II clinical trial 


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