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Review
. 2023 Feb 14;13(2):326.
doi: 10.3390/brainsci13020326.

Perampanel in Brain Tumor-Related Epilepsy: A Systematic Review

Payam Tabaee Damavandi  1 , Francesco Pasini  1 , Gaia Fanella  1 , Giulia Sofia Cereda  1 , Gabriele Mainini  1 , Jacopo C DiFrancesco  1 , Eugen Trinka  2   3   4 , Simona Lattanzi  5
Affiliations
Review

Perampanel in Brain Tumor-Related Epilepsy: A Systematic Review

Payam Tabaee Damavandi et al. Brain Sci. .

Abstract

Brain tumor-related epilepsy (BTRE) is a common comorbidity in patients with brain neoplasms and it may be either the first symptom or develop after the tumor diagnosis. Increasing evidence suggests that brain tumors and BTRE share common pathophysiological mechanisms. Glutamatergic mechanisms can play a central role in promoting both primary brain tumor growth and epileptogenesis. Perampanel (PER), which acts as a selective antagonist of glutamate α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors, may play a role both in the reduction in tumor growth and the control of epileptiform activity. This systematic review aimed to summarize the pre-clinical and clinical evidence about the antitumor properties, antiseizure effects and tolerability of PER in BTRE. Eight pre-clinical and eight clinical studies were identified. The currently available evidence suggests that PER can be an effective and generally well-tolerated therapeutic option in patients with BTRE. In vitro studies demonstrated promising antitumor activity of PER, while no role in slowing tumor progression has been demonstrated in rat models; clinical data on the potential antitumor activity of PER are scarce. Additional studies are needed to explore further the effects of PER on tumor progression and fully characterize its potentialities in patients with BTRE.

Keywords: AMPA receptors; brain tumor; epilepsy; glioblastoma; glioma; glutamate; perampanel; seizure.

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Conflict of interest statement

S.L. has received speaker’s or consultancy fees from Eisai, GW Pharmaceuticals, and UCB Pharma, and has served on advisory boards for Angelini Pharma, Arvelle Therapeutics, BIAL, EISAI, and GW Pharmaceuticals outside the submitted work. E.T. has received consultancy fees from Arvelle Therapeutics, Argenx, Clexio, Celegene, UCB Pharma, Eisai, Epilog, Bial, Medtronic, Everpharma, Biogen, Takeda, Liva-Nova, Newbridge, Sunovion, GW Pharmaceuticals, and Marinus; speaker fees from Arvelle Therapeutics, Bial, Biogen, Böhringer Ingelheim, Eisai, Everpharma, GSK, GW Pharmaceuticals, Hikma, Liva-Nova, Newbridge, Novartis, Sanofi, Sandoz and UCB Pharma; research funding (directly, or to his institution) from GSK, Biogen, Eisai, Novartis, Red Bull, Bayer, and UCB Pharma outside the submitted work. Eugen Trinka receives Grants from Austrian Science Fund (FWF), Österreichische Nationalbank, and the European Union. Eugen Trinka is the CEO of Neuroconsult Ges.m.b.H. The remaining authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow diagram of study selection process.
Figure 2
Figure 2
Mechanism of action of perampanel and its potential role in antitumor growth.
See this image and copyright information in PMC

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