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Ganciclovir concentrations in the cerebral extracellular space after valganciclovir treatment; a case study
  1. Inti Peredo1,2,
  2. Anders Helldén3,
  3. Nina Wolmer-Solberg2,
  4. Anton Pohanka3,
  5. Giuseppe Stragliotto2,4,
  6. Afsar Rahbar2,
  7. Lars Ståhle3,
  8. Bo-Michael Bellander1,
  9. Cecilia Söderberg-Nauclér2
  1. 1Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden
  2. 2Department of Medicine, Unit for Microbial Pathogenesis, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
  3. 3Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
  4. 4Department of Neurology, Karolinska University Hospital, Stockholm, Sweden


Nearly all glioblastomas (GBMs), brain tumours with very poor prognosis, are infected with human cytomegalovirus (CMV). The anti-CMV drug valganciclovir (VGCV) has shown promise as a treatment option for patients with GBM, but its penetration into the central nervous system (CNS) is unknown. Here we describe a patient with GMB receiving VGCV in whom an intracerebral microdialysis catheter was implanted and ganciclovir (GCV) concentrations in brain extracellular fluid (BECF) and serum were monitored. GCV was rapidly absorbed. Cmax values (at 3 h) in serum and BECF were 19.6 and 10.2 µmol/L, T½ values were 3.2 and 4.5 h, and plasma and BECF AUC0−∞ values were 90.7 and 75.9 µmol h/L, respectively. Thus, VGCV treatment results in significant intracerebral levels of GCV that may be sufficient for therapeutic effects. Further studies of this drug in patients with GBM are warranted.

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