Perampanel in brain tumor-related epilepsy: Observational pilot study

Marta Maschio, Alessia Zarabla, Andrea Maialetti, Diana Giannarelli, Tatiana Koudriavtseva, Veronica Villani, Silvana Zannino

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Possible loss of efficacy and potential interactions between antiepileptic drugs (AEDs) and chemotherapy could complicate the management of patients with brain tumor-related epilepsy (BTRE) that may expose patients to an increased risk of adverse events. Perampanel (PER) is a highly selective, noncompetitive, alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA)-type glutamate receptor antagonist. This study evaluates the effectiveness, QoL, cognition, and mood of PER in add-on therapy in BTRE patients. Material and Methods: Observational pilot study on the effectiveness of PER as add-on therapy in BTRE patients with uncontrolled seizures with a 6-month follow-up. Results: We recruited 26 BTRE patients. During the follow-up, 16 underwent chemotherapy and 11 radiotherapy; 11 had disease progression. Five patients dropped out. Mean daily PER dosage was 6.6 mg in the 21 patients who completed the follow-up and 6.4 mg in the ITT population. The mean number of seizures/month decreased from 10.8 ± 15.03 at baseline to 1.7 ± 4.34 in the 21 patients who reached the final follow-up. Responder rate was 88.4%: Eight patients were seizure-free, 15 had ≥50% seizure reduction, and 3 remained stable. Four patients (15.4%) reported AEs: 2 required PER dose reduction, and 2 dropped out. Neuropsychological, mood, and QoL questionnaires were not statistically different compared to baseline. There were no significant differences in seizure control in patients with/without IDH1 mutation and with/without MGMT methylation. Conclusions: Perampanel proved to be effective on seizure control in BRTE patients and to be well tolerated without negative effects on cognition and QoL. Perampanel could be a valid therapeutic option in BTRE.

Original languageEnglish
Article numbere01612
JournalBrain and Behavior
Volume10
Issue number6
DOIs
Publication statusPublished - Jun 1 2020

Keywords

  • antiepileptic drugs
  • brain tumors
  • BTRE
  • epilepsy
  • molecular factors
  • perampanel
  • QoL
  • responder rate

ASJC Scopus subject areas

  • Behavioral Neuroscience

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