Epilepsy in glioblastoma patients: basic mechanisms and current problems in treatment

Bruna, Jordi; Miró, Júlia; Velasco, Roser

doi:10.1586/ecp.13.12

Cited by 35 publications

(32 citation statements)

References 103 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These COX inhibitors might be particularly useful in controlling the concomitant symptoms of GBM, such as seizures. Current seizure management in patients with glioblastomas mainly relies on antiepileptic drugs (AEDs), which cause adverse effects, such as bone marrow toxicity, skin reactions and CNS toxicity, that are more common in patients with brain tumors than in other forms of epilepsy [4]. In addition, tumor-related epilepsies are highly resistant to current AEDs partially because of the overexpression of efflux transporter proteins in glia and endothelial cells of the BBB [4,89,90].…”

Section: Concluding Remarks and Future Perspectivesmentioning

confidence: 99%

See 1 more Smart Citation

Cyclooxygenase-2 in glioblastoma multiforme

Jiang¹,

Shi²

2017

Drug Discovery Today

104

103

View full text Add to dashboard Cite

Glioblastoma multiforme (GBM) represents the most prevalent brain primary tumor, yet there is a lack of effective treatment. With current therapies, fewer than 5% of patients with GBM survive more than 5 years after diagnosis. Mounting evidence from epidemiological studies reveals that the regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) is correlated with reduced incidence of GBM, suggesting that cyclooxygenase-2 (COX-2) and its major product within the brain, prostaglandin E2 (PGE2), are involved in the development and progression of GBM. Here, we highlight our current understanding of COX-2 in GBM proliferation, apoptosis, invasion, angiogenesis, and immunosuppression by focusing on recent in vitro and in vivo experimental data. We also discuss the feasibility of COX-2 as a therapeutic target for GBM in light of the latest human studies.

show abstract

Section: Concluding Remarks and Future Perspectivesmentioning

confidence: 99%

“…In addition, up to 60% of patients with GBM develop simple partial, complex partial, or generalized seizures, depending on the tumor loci. GBM-associated seizures represent a major obstacle to the tumor management and approximately 30% of patients can develop pharmacoresistance [4,5]. …”

Section: Introductionmentioning

confidence: 99%

Cyclooxygenase-2 in glioblastoma multiforme

Jiang¹,

Shi²

2017

Drug Discovery Today

104

103

View full text Add to dashboard Cite

show abstract

“…Compared to low-grade gliomas, significantly fewer studies have examined the effects of surgery on seizures in high-grade (WHO grade III–IV) gliomas, as surgical treatment is nearly exclusively focused on limiting progression and improving survival (Englot et al., 2012b; Bruna et al, 2013). In one large surgical series of 648 patients with glioblastoma, 24% presented with seizures, particularly in the setting of a grade III lesion or tumor location in the temporal lobe or superficial cortex (Chaichana et al, 2009b).…”

Section: Surgicaltherapymentioning

confidence: 99%

Epilepsy and brain tumors

Englot

Chang

Vecht

2016

Handbook of Clinical Neurology

169

117

View full text Add to dashboard Cite

Seizures are common in patients with brain tumors, and epilepsy can significantly impact patient quality of life. Therefore, a thorough understanding of rates and predictors of seizures, and the likelihood of seizure freedom after resection, is critical in the treatment of brain tumors. Among all tumor types, seizures are most common with glioneuronal tumors (70–80%), particularly in patients with frontotemporal or insular lesions. Seizures are also common in individuals with glioma, with the highest rates of epilepsy (60–75%) observed in patients with low-grade gliomas located in superficial cortical or insular regions. Approximately 20–50% of patients with meningioma and 20–35% of those with brain metastases also suffer from seizures. After tumor resection, approximately 60–90% are rendered seizure-free, with most favorable seizure outcomes seen in individuals with glioneuronal tumors. Gross total resection, earlier surgical therapy, and a lack of generalized seizures are common predictors of a favorable seizure outcome. With regard to anticonvulsant medication selection, evidence-based guidelines for the treatment of focal epilepsy should be followed, and individual patient factors should also be considered, including patient age, sex, organ dysfunction, comorbidity, or cotherapy. As concomitant chemotherapy commonly forms an essential part of glioma treatment, enzyme-inducing anticonvulsants should be avoided when possible. Seizure freedom is the ultimate goal in the treatment of brain tumor patients with epilepsy, given the adverse effects of seizures on quality of life.

show abstract

“…First, as epilepsy commonly develops among GBM patients (17), it may aid a reduction in the severity and number of epileptic episodes and alleviate the requirement for anti-epileptic drugs, which are associated with detrimental neuropsychological effects and often interfere with the therapeutic regimen (18,19). Second, KD may increase the efficacy of cancer therapy.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a ketogenic diet with concomitant intranasal perillyl alcohol as a novel strategy for the therapy of recurrent glioblastoma

et al. 2017

View full text Add to dashboard Cite

Abstract. It has been hypothesized that persistent ketotic hypoglycemia represents a potential therapeutic strategy against high-grade gliomas. Perillyl alcohol (POH) is a non-toxic, naturally-occurring, hydroxylated monoterpene that exhibits cytotoxicity against temozolomide-resistant glioma cells, regardless of O6-methylguanine-methyltransferase promoter methylation status. The present study aimed to evaluate the toxicity and therapeutic efficacy of intranasal POH when administered in combination with a ketogenic diet (KD) program for the treatment of patients with recurrent glioblastoma. The 32 enrolled patients were divided into two groups, KD or standard diet, with intranasal POH treatment (n=17 and n=15, respectively). The nutritional status and anthropometric parameters of the patients were measured. Patients that adhered to the KD maintained a strict dietary regimen, in addition to receiving 55 mg POH four times daily, in an uninterrupted administration schedule for three months. Neurological examination and magnetic resonance imaging analysis were used to monitor disease progression. A total of 9/17 patients in the KD group survived and maintained compliance with the KD. After three months of well-tolerated treatment, a partial response (PR) was observed for 77.8% (7/9) of the patients, stable disease (SD) in 11.1% (1/9) and 11.1% (1/9) presented with progressive disease (PD). Among the patients assigned to the standard diet group, the PR rate was 25% (2/8 patients), SD 25% (2/8) and PD 50% (4/8 patients). The patients assigned to the KD group presented with reduced serum lipid levels and decreased low-density lipoprotein cholesterol levels. These results are encouraging and suggest that KD associated with intranasal POH may represent a viable option as an adjunct therapy for recurrent GBM.

show abstract

Epilepsy in glioblastoma patients: basic mechanisms and current problems in treatment

Cited by 35 publications

References 103 publications

Cyclooxygenase-2 in glioblastoma multiforme

Cyclooxygenase-2 in glioblastoma multiforme

Epilepsy and brain tumors

Efficacy of a ketogenic diet with concomitant intranasal perillyl alcohol as a novel strategy for the therapy of recurrent glioblastoma

Contact Info

Product

Resources

About