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Dosing Optimization of CED Drug Delivery for DIPG

Journal of Neurosurgery
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Dr. Mark Souweidane, Director of Pediatric Neurosurgery at Weill Cornell Medicine

A recent publication in the Journal of Neurosurgery highlighted Dr. Souweidane's efforts to leverage software in order to better predict CED drug delivery in DIPG patients. This may improve researchers' ability to optimize dosing for drugs delivered by CED, such as chemotherapy. CED administration in DIPG patients is largely thanks to research funding by The Cure Starts Now.

Abstract

With increasing use of convection-enhanced delivery (CED) of drugs, the need for software that can predict infusion distribution has grown. In the context of a phase I clinical trial for pediatric diffuse intrinsic pontine glioma (DIPG), CED was used to administer an anti-B7H3 radiolabeled monoclonal antibody, iodine-124–labeled omburtamab. In this study, the authors retrospectively evaluated a software algorithm (iPlan Flow) for the estimation of infusate distribution based on the planned catheter trajectory, infusion parameters, and patient-specific MRI. The actual infusate distribution, as determined on MRI and PET imaging, was compared to the distribution estimated by the software algorithm. Similarity metrics were used to quantify the agreement between predicted and actual distributions.

Conclusion

In this study, the iPlan Flow software infusion simulation algorithm was evaluated for use in convection-enhanced delivery (CED) of drugs to the pediatric brainstem. The authors compared simulated outcomes with the actual radiolabeled infusion distribution and used similarity metrics to quantify the agreement between the actual and the estimated infusate distribution. The combined acceptance criteria were met for 8 of 10 evaluated patients, and based on this finding, the authors recommend the use of iPlan Flow software to optimize personalized CED treatment.

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