Polifeprosan 20, 3.85% carmustine slow release wafer in malignant glioma: patient selection and perspectives on a low-burden therapy

Lawrence Kleinberg Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD, USA Abstract: Polifeprosan 20 with carmustine (GLIADEL®) polymer implant wafer is a biodegradable compound containing 3.85% carmustine (BCNU, bischloroethylnitroso...

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Main Author: Kleinberg L
Format: Article
Language:English
Published: Dove Medical Press 2016-11-01
Series:Patient Preference and Adherence
Subjects:
Online Access:https://www.dovepress.com/1polifeprosan-20-385-carmustine-slow-release-wafer-in-malignant-g-peer-reviewed-article-PPA
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author Kleinberg L
author_facet Kleinberg L
author_sort Kleinberg L
collection DOAJ
description Lawrence Kleinberg Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD, USA Abstract: Polifeprosan 20 with carmustine (GLIADEL®) polymer implant wafer is a biodegradable compound containing 3.85% carmustine (BCNU, bischloroethylnitrosourea) implanted in the brain at the time of planned tumor surgery, which then slowly degrades to release the BCNU chemotherapy directly into the brain thereby bypassing the blood–brain barrier. Carmustine implant wafers were demonstrated to improve survival in randomized placebo-controlled trials in patients undergoing a near total resection of newly diagnosed or recurrent malignant glioma. Based on these trials and other supporting data, carmustine wafer therapy was approved for use for newly diagnosed and recurrent malignant glioma in the United States and the European Union. Adverse events are uncommon, and as this therapy is placed at the time of surgery, it does not add to patient treatment burden. Nevertheless, this therapy appears to be underutilized. This article reviews the evidence for a favorable therapeutic ratio for the patient and the potential barriers. Consideration of these issues is important for optimal use of this therapeutic approach and may be important as this technology and other local therapies are further developed in the future. Keywords: carmustine, wafer, gliadel, glioblastoma
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spelling doaj.art-b1f8c2e7cdea4c1d90b00c4db5082c142022-12-21T22:26:11ZengDove Medical PressPatient Preference and Adherence1177-889X2016-11-01Volume 102397240630199Polifeprosan 20, 3.85% carmustine slow release wafer in malignant glioma: patient selection and perspectives on a low-burden therapyKleinberg LLawrence Kleinberg Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD, USA Abstract: Polifeprosan 20 with carmustine (GLIADEL®) polymer implant wafer is a biodegradable compound containing 3.85% carmustine (BCNU, bischloroethylnitrosourea) implanted in the brain at the time of planned tumor surgery, which then slowly degrades to release the BCNU chemotherapy directly into the brain thereby bypassing the blood–brain barrier. Carmustine implant wafers were demonstrated to improve survival in randomized placebo-controlled trials in patients undergoing a near total resection of newly diagnosed or recurrent malignant glioma. Based on these trials and other supporting data, carmustine wafer therapy was approved for use for newly diagnosed and recurrent malignant glioma in the United States and the European Union. Adverse events are uncommon, and as this therapy is placed at the time of surgery, it does not add to patient treatment burden. Nevertheless, this therapy appears to be underutilized. This article reviews the evidence for a favorable therapeutic ratio for the patient and the potential barriers. Consideration of these issues is important for optimal use of this therapeutic approach and may be important as this technology and other local therapies are further developed in the future. Keywords: carmustine, wafer, gliadel, glioblastomahttps://www.dovepress.com/1polifeprosan-20-385-carmustine-slow-release-wafer-in-malignant-g-peer-reviewed-article-PPACarmustineWaferGliadelGliobalstoma.
spellingShingle Kleinberg L
Polifeprosan 20, 3.85% carmustine slow release wafer in malignant glioma: patient selection and perspectives on a low-burden therapy
Patient Preference and Adherence
Carmustine
Wafer
Gliadel
Gliobalstoma.
title Polifeprosan 20, 3.85% carmustine slow release wafer in malignant glioma: patient selection and perspectives on a low-burden therapy
title_full Polifeprosan 20, 3.85% carmustine slow release wafer in malignant glioma: patient selection and perspectives on a low-burden therapy
title_fullStr Polifeprosan 20, 3.85% carmustine slow release wafer in malignant glioma: patient selection and perspectives on a low-burden therapy
title_full_unstemmed Polifeprosan 20, 3.85% carmustine slow release wafer in malignant glioma: patient selection and perspectives on a low-burden therapy
title_short Polifeprosan 20, 3.85% carmustine slow release wafer in malignant glioma: patient selection and perspectives on a low-burden therapy
title_sort polifeprosan 20 3 85 carmustine slow release wafer in malignant glioma patient selection and perspectives on a low burden therapy
topic Carmustine
Wafer
Gliadel
Gliobalstoma.
url https://www.dovepress.com/1polifeprosan-20-385-carmustine-slow-release-wafer-in-malignant-g-peer-reviewed-article-PPA
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