# Deliver drugs and cells to the brain through the nose

Source: https://onco.cc/ideas/idea-bio2-intranasal-delivery/  
OnCo record `idea-bio2-intranasal-delivery` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Summary

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.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- 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.
- Proposed test: 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
- Actor: research

## Sources

- Bottleneck evidence (The brain: barrier and sanctuary): Stupp et al., Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma (NEJM 2005): https://doi.org/10.1056/NEJMoa043330

## Connected records

- cancers: [Glioma & glioblastoma](https://onco.cc/cancers/glioblastoma/)
- technologies: [CAR-NK & CAR-macrophage](https://onco.cc/technologies/car-nk-macrophage/), [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Oncolytic viruses](https://onco.cc/technologies/oncolytic-virus/)
- terms: [Blood-brain barrier (BBB)](https://onco.cc/terms/blood-brain-barrier/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [The brain: barrier and sanctuary](https://onco.cc/bottlenecks/b-brain-delivery/)

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