ACT-13 RESPONSE TO SEIZURE AND TUMOR-PROGRESSION BY TREATMENT WITH PERAMPANEL IN PATIENTS WITH GLIOMAS
BACKGROUND Increased extracellular glutamate level activates AMPA type glutamate receptors (AMPA-receptor) and induces seizures. Antagonistic activation of AMPA-receptors inhibits epilepsy and glioma progression in vivo and in vitro studies. PATIENTS AND METHODS (1) We tested perampanel (PER), an AMPA-receptor antagonist, in fifteen glioma patients with uncontrolled epilepsy. Seizure response, PER concentration, and tumor volume were assessed. (2) We tested PER in thirteen glioma patients (gr
... ioma patients (gr 2- 3 cases, gr 3- 4 cases, and gr 4- 4cases) after the initial treatment of surgery and RT (and CT). RESULTS (1) An objective seizure response was observed in 13 analyzed patients (100%) with 8 cases (62%) of seizure-freedom. Median plasma concentration of PER was 232 ng/ml in patients with 4mg/day PER and 518 ng/ml in patients with 8mg/day PER. High intensity lesions of MRI-FLAIR images were assessed volumetrically to analyze the tumor size. The volume reduction was detected during the 6 months period in correlation with the plasma PER levels. (2) All the 13 cases treated with PER after the initial treatment was seizure free. Two cases of gr 4 were died at 18 and 20 months after the surgical treatment. Other 11 cases are survival-free. CONCLUSION PER treatment was effective in uncontrolled epilepsy with gliomas. MRI images showed the inhibition of tumor-progression. PER may effective for the inhibition of tumor progression.