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Review
. 2025 Nov:226:115695.
doi: 10.1016/j.addr.2025.115695. Epub 2025 Sep 25.

Drug delivery strategies for paediatric diffuse midline gliomas

Stefana Duca  1 , Sara Jamshidi Parvar  2 , Luke Kumeta  3 , Tracey D Bradshaw  3 , Weng C Chan  3 , Felicity de Cogan  4 , Karolina Dziemidowicz  2 , Pavel Gershkovich  3 , Maria Marlow  4 , Christopher J Morris  2 , David Shorthouse  2 , Andrew L Lewis  5
Affiliations
Review

Drug delivery strategies for paediatric diffuse midline gliomas

Stefana Duca et al. Adv Drug Deliv Rev. 2025 Nov.

Abstract

Diffuse midline gliomas (DMGs) are a highly aggressive and inoperable type of paediatric brain tumours, with a median survival of less than one year. Therapeutic progress has been hindered by the tumour's anatomical location, its extensive molecular heterogeneity, and the restrictive nature of the blood brain barrier (BBB) in drug delivery. This article explores the current therapeutic landscape of DMG and evaluates emerging drug delivery strategies, including oral, intravenous and intrathecal administration, convection-enhanced delivery (CED), and intranasal approaches, designed to improve drug access to the brain. Advancements in these methods, combined with targeted therapies tailored to the tumour's unique molecular features, represent a critical pathway towards improving clinical outcomes for DMG patients.

Keywords: CED; DMG, DIPG; Drug delivery; Intranasal; Intrathecal; Paediatric gliomas.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Given their role as Guest Editor,Karolina Dziemidowicz had no involvement in the peer review of this article and had no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to another journal editor. The rest of the authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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