Evidence map›Paper›PMID 29016900›Full record

ReviewNeuro-oncology2018

Is the blood-brain barrier really disrupted in all glioblastomas? A critical assessment of existing clinical data.

Jann N Sarkaria, Leland S Hu, Ian F Parney, Deanna H Pafundi, Debra H Brinkmann, Nadia N Laack, Caterina Giannini, Terence C Burns, Sani H Kizilbash, Janice K Laramy and 7 more

Open access · bronzeAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Neuro-oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 457 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
457citing papers in PubMed, 3 pooled it
20.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

457 citing papers in PubMed, 3 syntheses or guidelines pooled it, 676 citations in OpenAlex.

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397 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 4 institutions in 1 country.

Jann N SarkariaMayo Clinic, Rochester, Minnesota (J.N.S., I.F.P., D.H.P., D.H.B., N.N.L., C.G., T.C.B., S.H.K., T.J.K., P.D.B., E.G., J.C.B.).
Leland S HuMayo Clinic, Scottsdale, Arizona (L.S.H., K.R.S.).
Ian F ParneyMayo Clinic, Rochester, Minnesota (J.N.S., I.F.P., D.H.P., D.H.B., N.N.L., C.G., T.C.B., S.H.K., T.J.K., P.D.B., E.G., J.C.B.).
Deanna H PafundiMayo Clinic, Rochester, Minnesota (J.N.S., I.F.P., D.H.P., D.H.B., N.N.L., C.G., T.C.B., S.H.K., T.J.K., P.D.B., E.G., J.C.B.).
Debra H BrinkmannMayo Clinic, Rochester, Minnesota (J.N.S., I.F.P., D.H.P., D.H.B., N.N.L., C.G., T.C.B., S.H.K., T.J.K., P.D.B., E.G., J.C.B.).
Nadia N LaackMayo Clinic, Rochester, Minnesota (J.N.S., I.F.P., D.H.P., D.H.B., N.N.L., C.G., T.C.B., S.H.K., T.J.K., P.D.B., E.G., J.C.B.).
Caterina GianniniMayo Clinic, Rochester, Minnesota (J.N.S., I.F.P., D.H.P., D.H.B., N.N.L., C.G., T.C.B., S.H.K., T.J.K., P.D.B., E.G., J.C.B.).
Terence C BurnsMayo Clinic, Rochester, Minnesota (J.N.S., I.F.P., D.H.P., D.H.B., N.N.L., C.G., T.C.B., S.H.K., T.J.K., P.D.B., E.G., J.C.B.).
Sani H KizilbashMayo Clinic, Rochester, Minnesota (J.N.S., I.F.P., D.H.P., D.H.B., N.N.L., C.G., T.C.B., S.H.K., T.J.K., P.D.B., E.G., J.C.B.).
Janice K LaramyUniversity of Minnesota, Minneapolis, Minnesota (J.K.L., W.F.E.).
Kristin R SwansonMayo Clinic, Scottsdale, Arizona (L.S.H., K.R.S.).
Timothy J KaufmannMayo Clinic, Rochester, Minnesota (J.N.S., I.F.P., D.H.P., D.H.B., N.N.L., C.G., T.C.B., S.H.K., T.J.K., P.D.B., E.G., J.C.B.).
Paul D BrownMayo Clinic, Rochester, Minnesota (J.N.S., I.F.P., D.H.P., D.H.B., N.N.L., C.G., T.C.B., S.H.K., T.J.K., P.D.B., E.G., J.C.B.).
Nathalie Y R AgarHarvard Medical School, Boston, Massachusetts (N.Y.R.A.).
Evanthia GalanisMayo Clinic, Rochester, Minnesota (J.N.S., I.F.P., D.H.P., D.H.B., N.N.L., C.G., T.C.B., S.H.K., T.J.K., P.D.B., E.G., J.C.B.).
Jan C BucknerMayo Clinic, Rochester, Minnesota (J.N.S., I.F.P., D.H.P., D.H.B., N.N.L., C.G., T.C.B., S.H.K., T.J.K., P.D.B., E.G., J.C.B.).
William F ElmquistMayo Clinic, Rochester, Minnesota (J.N.S., I.F.P., D.H.P., D.H.B., N.N.L., C.G., T.C.B., S.H.K., T.J.K., P.D.B., E.G., J.C.B.).
Mayo Clinic · USMayo Clinic in Arizona · USUniversity of Minnesota System · USHarvard University · US

Funding

Targeted MV-CEA as a Potent Antitumor Agent against GBMP50CA108961 · NCI · MAYO CLINIC ROCHESTER · PI O'NEILL, BRIAN PATRICK · 2004 to 2015
$22.5M
"Research Supplement to Promote Diversity in Health-Related Research", as part of Moffitt PS-OC, "Cancer as a Complex adaptive System"U54CA193489 · NCI · H. LEE MOFFITT CANCER CTR & RES INST · PI ANDERSON, ALEXANDER ROBERTSON ALLAN, GATENBY, ROBERT A · 2015 to 2020
$12.5M
Trans Network ProjectU54CA210180 · NCI · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · PI WHITE, FOREST M · 2016 to 2020
$10.2M
The Physi(ologi)cal Microenvironment and its Role in Tumor Invasion and MetastaseU54CA143970 · NCI · H. LEE MOFFITT CANCER CTR & RES INST · PI GATENBY, ROBERT A · 2009 to 2014
$9.3M
Patient-specific predictive modeling that integrates advanced cancer imagingR01CA164371 · NCI · UNIVERSITY OF WASHINGTON · PI KINAHAN, PAUL E., SWANSON, KRISTIN R · 2011 to 2015
$4.5M
Quantifying Multiscale Competitive Landscapes of Clonal Diversity in GlioblastomaU01CA220378 · NCI · MAYO CLINIC ARIZONA · PI HU, LELAND, SWANSON, KRISTIN R · 2017 to 2021
$4.3M
Novel Tools for Evaluation and Prediction of Radiotherapy Response in IndividualR01NS060752 · NINDS · UNIVERSITY OF WASHINGTON · PI SWANSON, KRISTIN R · 2009 to 2013
$1.6M
NCI NIH HHS U01 CA220378NIH HHS P50CA108961NIH HHS R01 CA164371NIH HHS R01 NS060752NIH HHS RO1NS077921NIH HHS U54 CA143970NIH HHS U54 CA193489NIH HHS U54CA210180
6 · The paper itself

Abstract

The blood-brain barrier (BBB) excludes the vast majority of cancer therapeutics from normal brain. However, the importance of the BBB in limiting drug delivery and efficacy is controversial in high-grade brain tumors, such as glioblastoma (GBM). The accumulation of normally brain impenetrant radiographic contrast material in essentially all GBM has popularized a belief that the BBB is uniformly disrupted in all GBM patients so that consideration of drug distribution across the BBB is not relevant in designing therapies for GBM. However, contrary to this view, overwhelming clinical evidence demonstrates that there is also a clinically significant tumor burden with an intact BBB in all GBM, and there is little doubt that drugs with poor BBB permeability do not provide therapeutically effective drug exposures to this fraction of tumor cells. This review provides an overview of the clinical literature to support a central hypothesis: that all GBM patients have tumor regions with an intact BBB, and cure for GBM will only be possible if these regions of tumor are adequately treated.

Indexed as

Drug Delivery SystemsAnimalsBlood-Brain BarrierBrainBrain NeoplasmsContrast MediaGlioblastomaHumansContrast Mediablood brain barrierdrug therapyglioblastomamagnetic resonance imaging

Identifiers

PMID29016900
PMCPMC5777482
OpenAlexW2752314762

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.