Marta Maschio1, Giada Pauletto2, Alessia Zarabla1, Andrea Maialetti1, Tamara Ius2, Veronica Villani3, Alessandra Fabi4, Tatiana Koudriavtseva3, Diana Giannarelli5. 1. a Center for Tumor-related Epilepsy, UOSD Neurology , Regina Elena National Cancer Institute , Rome , Italy. 2. b Neurology Unit, Department of Neurosciences , S. Maria della Misericordia University Hospital , Udine , Italy. 3. c UOSD Neurology , Regina Elena National Cancer Institute , Rome , Italy. 4. d Oncology Unit , Regina Elena National Cancer Institute , Rome , Italy. 5. e Biostatistic Unit , Regina Elena National Cancer Institute , Rome , Italy.
Abstract
INTRODUCTION: Epilepsy occurs in 35-70% of patients with gliomas; glutamate plays a central role via AMPA-receptor activation, which is involved both in seizure activity and tumor growth. We conducted a retrospective study on brain tumor-related epilepsy patients (BTRE) treated with perampanel in add-on (PER) for 12 months, to evaluate efficacy and tollerability, according to real-life clinical practice. MATERIALS AND METHODS: Medical records of eleven patients (9 males, mean age 54 years) with glioma and epilepsy treated with PER in add-on, for inadequate seizure control or adverse events (AEs) from previous antiepileptic drugs (AEDs) therapy, were reviewed. Data collected included: tumor history, molecular factors, systemic therapy, type and number of seizures and concomitant AEDs, and AEs. RESULTS: After 12 months of PER therapy, five patients were seizure-free, 4 had a seizure reduction ≥50% and the seizure frequency was unchanged in 2 patients. Responder rate was 81.8%. Two patients reported AEs; PER dose was reduced only in the one case. The final median dose of PER was 7.3 mg/day. We didn't find statistically significant differences in the comparison between mean values pre, mean values post and the average of decreasing number of seizures related to: histology, presence/absence of chemotherapy, radiotherapy, progression disease, KPS, IDH1, MGMT. DISCUSSION: Despite the limitations due to small number of patients in a retrospective study, the high rate of responder and seizure-free patients suggest that PER could be a therapeutic option in BTRE. Prospective controlled studies are needed to confirm our data.
INTRODUCTION:Epilepsy occurs in 35-70% of patients with gliomas; glutamate plays a central role via AMPA-receptor activation, which is involved both in seizure activity and tumor growth. We conducted a retrospective study on brain tumor-related epilepsypatients (BTRE) treated with perampanel in add-on (PER) for 12 months, to evaluate efficacy and tollerability, according to real-life clinical practice. MATERIALS AND METHODS: Medical records of eleven patients (9 males, mean age 54 years) with glioma and epilepsy treated with PER in add-on, for inadequate seizure control or adverse events (AEs) from previous antiepileptic drugs (AEDs) therapy, were reviewed. Data collected included: tumor history, molecular factors, systemic therapy, type and number of seizures and concomitant AEDs, and AEs. RESULTS: After 12 months of PER therapy, five patients were seizure-free, 4 had a seizure reduction ≥50% and the seizure frequency was unchanged in 2 patients. Responder rate was 81.8%. Two patients reported AEs; PER dose was reduced only in the one case. The final median dose of PER was 7.3 mg/day. We didn't find statistically significant differences in the comparison between mean values pre, mean values post and the average of decreasing number of seizures related to: histology, presence/absence of chemotherapy, radiotherapy, progression disease, KPS, IDH1, MGMT. DISCUSSION: Despite the limitations due to small number of patients in a retrospective study, the high rate of responder and seizure-freepatients suggest that PER could be a therapeutic option in BTRE. Prospective controlled studies are needed to confirm our data.
Authors: Marco Zoccarato; Lucia Nardetto; Anna Maria Basile; Bruno Giometto; Vittorina Zagonel; Giuseppe Lombardi Journal: Front Oncol Date: 2021-03-22 Impact factor: 6.244
Authors: Falko Lange; Jens Hartung; Clara Liebelt; Julius Boisserée; Tobias Resch; Katrin Porath; Julia Hörnschemeyer; Gesine Reichart; Tina Sellmann; Valentin Neubert; Stephan Kriesen; Guido Hildebrandt; Elisabeth Schültke; Rüdiger Köhling; Timo Kirschstein Journal: Front Neurosci Date: 2020-11-30 Impact factor: 4.677