The following is a summary of “PerSurge (NOA-30) phase II trial of perampanel treatment around surgery in patients with progressive glioblastoma,” published in the January 2024 issue of Oncology by Heuer et al.
Glioblastoma, a highly malignant primary brain tumor lacking proven standard therapy for recurrence, exhibits neuron-tumor network connectivity through AMPA-receptor subtype synapses. Preclinical studies demonstrated effective targeting of this connectivity with perampanel, an FDA-approved antiepileptic AMPA receptor inhibitor. The PerSurge trial, a phase IIa clinical and translational study, revolves around the surgical resection of progressive or recurrent glioblastoma. In this double-blind superiority trial, patients (n = 66) are randomized 1:1 to receive either a placebo or perampanel.
The study spans a 60-day treatment and observation period, initiating 30 days before planned surgical resection. Safety MRI is performed, and co-primary endpoints include analyzing tumor cell network connectivity from resected tissue at the single-cell transcriptome level and AI-based assessment of tumor growth dynamics in T2/FLAIR MRI scans pre-resection. Secondary endpoints encompass various imaging parameters, quality of life, cognitive testing, overall and progression-free survival, and the frequency of epileptic seizures. The trial aims to provide initial insights into perampanel’s clinical efficacy and tolerability in recurrent glioblastoma.
As a repurposed drug inhibiting neuron-glioma synapses and glioblastoma growth in preclinical models, the success of perampanel in the clinical setting could mark a crucial breakthrough, indicating the potential benefits of disrupting neuron-cancer interactions for patients. This endeavor lays the groundwork for a larger confirmatory trial, shaping the landscape of glioblastoma therapeutic strategies.
Source: bmccancer.biomedcentral.com/articles/10.1186/s12885-024-11846-1
