Perampanel in patients with brain tumor-related epilepsy in real-life clinical practice: a retrospective analysis

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.

Keywords:

• Antiepileptic drugs
• brain tumor-related epilepsy
• molecular factors
• perampanel
• responder rate

Acknowledgments

We thank Dr. Luca Cantini for Medical Writing Services in drafting this manuscript. Editorial assistance was funded by Eisai S.R.L.; Eisai S.R.L. did not exert any influence on the contents of the present article.

Availability of data and materials

The dataset analyzed for the current study is available from the Biostatistic unit of Regina Elena National Cancer Institute on reasonable request.

Disclosure statement

Dr. Marta Maschio has received support for travel to congresses from EISAI srl; has participated in scientific advisory boards for EISAI; has participated in pharmaceutical industry-sponsored symposia for UCB Pharma; has received research grants from UCB Pharma. No conflicts of interest are declared for the other Authors.

Ethics approval and consent to participate

The Institute’s Ethical Committee approved the present retrospective study; for this type of study formal consent is not required.

Additional information

Funding

Editorial assistance was funded by EISAI s.r.l.; EISAI s.r.l. did not exert any influence on the contents of the present article.