Is the blood–brain barrier really disrupted in all glioblastomas? A critical assessment of existing clinical data

Nearly all glioblastoma (GBM) patients have tumor regions with an intact blood-brain barrier (BBB).

• The blood-brain barrier limits the delivery of many cancer treatments to brain tumors.
• There is a widespread belief that the BBB is entirely disrupted in GBM patients due to the accumulation of contrast material.
• However, substantial clinical evidence indicates that significant tumor regions retain an intact BBB.
• Drugs with poor permeability across the BBB are unlikely to effectively treat tumor cells in these regions.
• Effective treatment of GBM may require targeting areas of the tumor where the BBB remains intact.

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