Seizures and Tumor Progression in Glioma Patients with Uncontrollable Epilepsy Treated with Perampanel

• Published in: Anticancer research Vol. 38; no. 7; pp. 4361 - 4366
• Main Authors: Izumoto, Shuichi, Miyauchi, Masaharu, Tasaki, Takayuki, Okuda, Takeshi, Nakagawa, Nobuhiro, Nakano, Naoki, Kato, Amami, Fujita, Mitsugu
• Format: Journal Article
• Language: English
• Published: Greece International Institute of Anticancer Research 01.07.2018
• Subjects: Convulsions & seizures; Epilepsy; Glioma; Glutamic acid receptors; In vivo methods and tests; Lesions; Magnetic resonance imaging; NMR; Nuclear magnetic resonance; Patients; Plasma levels; Receptors; Seizing; Seizures; Tumors; α-Amino-3-hydroxy-5-methyl-4-isoxazole propionic acid; α-Amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors; epilepsy; perampanel; AMPA receptor; Glioma; antiepileptic drug
• ISSN: 0250-7005; 1791-7530
• DOI: 10.21873/anticanres.12737

Excessive extracellular glutamate activates AMPA-type glutamate receptors (AMPA receptors) and induces seizures. Antagonistic activation of AMPA receptors inhibits epilepsy and glioma growth in in vitro and in vivo studies. This study was conducted to evaluate the clinical impacts of perampanel (PER), a novel AMPA receptor antagonist, on seizures and tumor progression in glioma patients with uncontrollable epilepsy. Twelve glioma patients with uncontrollable epilepsy were treated with PER. Seizure response, PER concentration, and tumor volume were assessed. Obvious seizure control was observed in 10 analyzed patients (100%) and 6 patients (60%) became seizure-free. Median plasma concentrations of PER were 296 ng/ml in those with 4 mg/day PER treatment and 518 ng/ml in those with 8 mg/day PER treatment. High-intensity lesions in fluid-attenuated inversion recovery of magnetic resonance imaging (MRI) were volumetrically assessed to analyze tumor size. Volume reduction was detected within 6 months in correlation with increased plasma levels of PER. PER treatment was effective in uncontrollable epilepsy with gliomas. MRI images showed the inhibition of tumor growth.