Brain cancer is considered one of the most vicious and devastating tumors
owing to its poor prognosis and high mortality rate. Common strategies for
treatment include surgery, radiation, and chemotherapy. Unfortunately, these are
limited due to their invasive nature and the inherent difficulties of brain surgery, given
there is a high possibility of tumor relapse. Further, radiation and chemotherapy have a
non-selective harmful effect on normal tissues, accompanied by limited drug delivery
due to the presence of various barriers, including the blood-brain barrier. For this
reason, the theranostic approach was developed by incorporating one or more
therapeutic and diagnostic agents in a single nanocarrier moiety which could be
modulated at its surface with certain proteins, legend, surface markers, or a stimuli-responsive agent that is capable of selectively targeting the tumor site after passing
through the blood-brain barrier. This new field will permit the early and precise
detection of cancer tissue, facilitate the process of drug delivery and assist in
monitoring treatment outcomes. Micelles are considered one of the most commonly
used nanocarriers due to their high stability and loading capacity, along with efficient
release controlling properties. This chapter will present brief information about brain
anatomy and cancer, and will discuss the main strategies implemented in the diagnosis
and treatment of brain cancers. Furthermore, it will introduce the theranostic micelle
approach by highlighting micelles types and preparation techniques, as well as explain
the different barriers and approaches to targeting.
Keywords: Active targeting, Blood-brain barrier, Blood-brain tumor barrier, Brain cancer, Brain tumor stem cells, Chemotherapy, Computed tomography, Focused ultrasound, Gene therapy, Magnetic resonance imaging, Optical imaging, Paracellular, Passive targeting, Photodynamic therapy, Photothermal therapy, Polymeric micelles, Stimuli-responsive targeting, Theranostic, Transcellular, Tumor microenvironment.
