ideasIdea
Deliver drugs and cells to the brain through the nose
The nerves at the top of the nose lead directly into the brain, bypassing the barrier. Nasal delivery of drugs, and even immune cells, has worked in animals.
Intranasal administration reaches the brain along olfactory and trigeminal pathways, and preclinical work has delivered chemotherapy, oncolytic virus and natural killer cells to glioma models by this route. Human doses of intranasal insulin and perampanel demonstrate the route works pharmacologically, but delivered fractions are small and highly formulation-dependent.
Hypothesis
An optimised intranasal formulation delivers a therapeutically relevant concentration to human brain tissue, measurable in resected tumour or by microdialysis, at a fraction of the systemic exposure required intravenously.
Rationale
The route completely bypasses the barrier and requires no device or surgery, so it would be uniquely suitable for repeated or chronic dosing and for use in resource-limited settings. The key unknown is human delivered fraction, which is directly measurable.
What would test it
A pharmacokinetic study in patients scheduled for tumour resection: intranasal dosing before surgery with drug quantification in resected tumour and plasma to establish the brain-to-plasma ratio achieved.
Maturity
preclinical evidence
Who has to act
research
Cost to try
Medium ($1M to $50M)
Years to first evidence
8
Bottlenecks it attacks
- The brain: barrier and sanctuary · Most drugs cannot cross into the brain, so brain tumours and brain metastases lag every other site.
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.