Table 1.
Advantages | Disadvantages |
---|---|
Near real-time measurement of unbound drug near site of action in the brain; distinction between extracellular space and other compartments |
Invasive technique |
Simultaneous measurement of drug pharmacokinetics in brain and plasma contributes to decreased interpatient variability |
Requires hospitalization |
CNS concentration–time profiles of drugs can be determined using a relatively small number of patients |
Expensive, particularly if hospitalization is prolonged beyond clinically indicated durations (i.e., prolonged dialysate collections) |
Serial sample collections can be done while patients are awake and in the course of standard clinical care |
Catheter calibration is needed to estimate the true drug concentration in tissue |
Safe with low rates of bleeding or infections (comparable to other intracerebral monitoring techniques) |
Sensitive analytical methods are needed to detect drug concentrations in the dialysate samples |
More than one catheter can be placed at one time, enabling concurrent measurement in tumor core, peritumoral tissue and normal brain |
In vitro testing is required to determine if the drug of interest is a candidate for microdialysis; many new targeted therapies and large proteins will not be good candidates |
Accuracy of catheter placement can be confirmed with imaging studies |
Accurate placement of catheter into regions of tumor is challenging |
The major advantages and limitations of the microdialysis technique for clinical translational studies in neuro-oncology.