title: [Perampanel in the treatment of a patient with glioblastoma multiforme without IDH1 mutation and without MGMT promotor methylation].
abstract: Malignant gliomas like glioblastoma multiforme (GBM) release glutamate which causes excitotoxic death to surrounding neurons, thereby vacating room for tumor expansion. We report the case of a patient with GBM treated with the AMPA receptor blocker Perampanel (PER) in combination therapy for partial seizures. Histological work-up of a biopsy showed the tissue of a GBM without mutation of the isocitrate dehydrogenase 1 (IDH1) and without promotor methylation of the O6-methylguanine-DNA methyltransferase (MGMT). In a group of patients with IDH 1 wild type and non-methylated MGMT a median survival of 199 days after surgery (i. e. 6.5 months) was described. Our patient lived about one year longer. PER rendered our patient seizure-free for at least the last seven months of his life. It was well tolerated and did not increase the toxicity of temozolomide. When choosing an antiepileptic drug (AED) for the treatment of seizures in patients with malignant brain tumors, the efficacy, the tolerability and perhaps possible effects on tumor progression of the AED should be taken into account.
authors.affiliation: Klinik und Poliklinik für Neurologie, Universität Rostock.
authors.forename: J
authors.initials: J
authors.lastname: Rösche
authors.affiliation: Chirurgische Klinik und Poliklinik, Abteilung für Neurochirurgie, Universitätsmedizin Rostock.
authors.forename: J
authors.initials: J
authors.lastname: Piek
authors.affiliation: Klinik und Poliklinik für Strahlentherapie, Universitätsmedizin Rostock.
authors.forename: G
authors.initials: G
authors.lastname: Hildebrandt
authors.affiliation: Institut für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Rostock.
authors.forename: A
authors.initials: A
authors.lastname: Grossmann
authors.affiliation: Klinik und Poliklinik für Neurologie, Universität Rostock.
authors.forename: T
authors.initials: T
authors.lastname: Kirschstein
authors.affiliation: Klinik und Poliklinik für Neurologie, Universität Rostock.
authors.forename: R
authors.initials: R
authors.lastname: Benecke
mesh_terms: D000477:Alkylating Agents / Q000009:adverse effects / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000235:genetics* / Q000601:surgery; D003606:Dacarbazine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D004828:Epilepsies, Partial / Q000150:complications / Q000188:drug therapy; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D005909:Glioblastoma / Q000188:drug therapy* / Q000235:genetics* / Q000601:surgery; D006801:Humans; D007521:Isocitrate Dehydrogenase / Q000235:genetics*; D008279:Magnetic Resonance Imaging; D008297:Male; D008745:Methylation; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D009570:Nitriles; D019853:O(6)-Methylguanine-DNA Methyltransferase / Q000235:genetics*; D011401:Promoter Regions, Genetic; D011728:Pyridones / Q000627:therapeutic use*; D016019:Survival Analysis; D000077204:Temozolomide
chemical_list: D000477:Alkylating Agents; D018691:Excitatory Amino Acid Antagonists; D009570:Nitriles; D011728:Pyridones; D003606:Dacarbazine; D007521:Isocitrate Dehydrogenase; C543588:IDH1 protein, human; D019853:O(6)-Methylguanine-DNA Methyltransferase; C551441:perampanel; D000077204:Temozolomide