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Perampanel for the Reduction of Seizure Frequency in Patients With High-grade Glioma and Focal Epilepsy

Primary Purpose

Intractable Epilepsy, Malignant Glioma, Seizure Disorder

Status
Terminated
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Anticonvulsant Agent
Perampanel
Quality-of-Life Assessment
Questionnaire Administration
Sponsored by
Mayo Clinic
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Intractable Epilepsy

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • The subject, or the subject's legally acceptable representative is willing to participate in a clinical trial, provides written informed consent, and subject provides written assent, as required by the Mayo Clinic Institutional Review Board (IRB) policy involving human subjects. In the event of subject lacking the capacity or losing the ability to consent, consent will be deferred to subject's legally acceptable representative
  • Subjects that satisfy one of the following diagnostic criteria:

    • Patients with established clinical diagnoses of biopsy-proven high-grade glioma and epilepsy refractory to at least 1, drug with a seizure frequency of at least 1 seizure episode per month prior to baseline visit
  • Subjects with body weight of >= 40 kg and =< 125 kg at screening

Exclusion Criteria:

  • Subject has serious cardiac, respiratory, renal, gastrointestinal, hematologic or other medical condition as determined by the investigator to potentially interfere with the study
  • Subjects with glioblastoma not following Stupp protocol for treatment of glioblastoma
  • History of status epilepticus in the 6 months prior to screening or a history of seizure clusters progressing to status epilepticus
  • Clinically significant suicide risk as determined by the clinician
  • Positive test result for drugs of abuse at baseline without documented history of stable use for medical purposes or past medical history of drug and/or alcohol abuse
  • Pregnant or breast-feeding
  • Subjects treated with PER prior to baseline
  • Prior felony conviction disclosed by the patient or previously stated in medical record
  • History of violent behavior
  • Clinically significant laboratory abnormality at screening or baseline visits, as determined by the investigators
  • Use of an investigational drug or device within 20 days prior to treatment day 1
  • Repeated radiation therapy for tumor regrowth
  • Subjects that plan to undergo tumor resection on or after baseline visit
  • Uncontrolled psychiatric disorder at baseline
  • Subjects who report active suicidal attempts or suicidality including subjects with a history of suicide attempts or suicidality determined to be clinically significant by investigators at screening
  • Biopsy proven high-grade glioma established 3 months prior to enrollment

Sites / Locations

  • Mayo Clinic in Florida

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Arm A (perampanel)

Arm B (ASD)

Arm Description

Patients receive perampanel PO QD for 40 weeks in the absence of disease progression or unacceptable toxicity.

Patients receive ASD per standard of care for 40 weeks in the absence of disease progression or unacceptable toxicity.

Outcomes

Primary Outcome Measures

Number of Patients With a High-grade Glioma Who Achieve a > 50% Reduction in Focal Seizures With Perampanel (PER) 4 mg Daily After Failing 1 or More Anti-seizure Drugs (ASDs)
Will compare seizure frequency before and 3 months after treatment with monotherapy and adjunctive PER and use descriptive statistics to demonstrate differences in responders. A P-value < 0.05 will be used to reflect statistical significance.
Number of Patients With a High-grade Glioma Who Achieve a > 50% Reduction in Focal Seizures With PER 4 mg Daily After Failing 1 or More ASDs
Will compare seizure frequency before and 6 months after treatment with monotherapy and adjunctive PER and use descriptive statistics to demonstrate differences in responders. A P-value < 0.05 will be used to reflect statistical significance.
Number of Participants Alive at 3 Months With High-grade Glioma Treated With PER
Chi-square and Student T-test will be used to measure differences in assessment and change during the study period.
Decline in Neuropsychological Function
Chi-square and Student T-test will be used to measure differences in assessment and change during the study period.

Secondary Outcome Measures

Full Information

First Posted
November 11, 2020
Last Updated
May 27, 2023
Sponsor
Mayo Clinic
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1. Study Identification

Unique Protocol Identification Number
NCT04650204
Brief Title
Perampanel for the Reduction of Seizure Frequency in Patients With High-grade Glioma and Focal Epilepsy
Official Title
A Phase IV, Prospective, Open-Label, Parallel Study Evaluating the Effect of an Adjunctive Anti-Seizure Medication Using a Glutamatergic Modulator in Patients With Focal Epilepsy and High-Grade Glioma
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Terminated
Why Stopped
The funding sponsor, EISAI, sold the US rights to the medication and can no longer provide it to patients for the study.
Study Start Date
December 4, 2020 (Actual)
Primary Completion Date
April 30, 2023 (Actual)
Study Completion Date
April 30, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Mayo Clinic

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This phase IV trial studies the side effects and how well perampanel works in reducing seizure frequency in patients with high-grade glioma and focal epilepsy. Perampanel is a drug used to treat seizures. Giving perampanel together with other anti-seizure drugs may work better in reducing seizure frequency in patients with high-grade glioma and focal epilepsy compared to alternate anti-seizure drugs alone.
Detailed Description
PRIMARY OBJECTIVE: I. Demonstrate the efficacy and safety of perampanel (PER) on seizure frequency in adult patients with biopsy-proven high-grade glioma and focal epilepsy compared with alternate anti-seizure drugs (ASDs). SECONDARY OBJECTIVES: I. To assess the change in neurocognitive function and brain magnetic resonance imaging (MRI) progression over the course of PER treatment with a daily dose of 4 mg (up to -8mg) in patients with biopsy-proven high-grade glioma and focal epilepsy compared with alternate ASDs. II. To identify a biomarker-specific response to seizure-reduction in patients treated with PER in patients with a biopsy-proven high-grade glioma (i.e., IDH-mutant versus [vs] wildtype). OUTLINE: Patients are assigned to 1 of 2 groups. GROUP A: Patients receive perampanel orally (PO) once daily (QD) for 40 weeks in the absence of disease progression or unacceptable toxicity. GROUP B: Patients receive ASD per standard of care for 40 weeks in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up for 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intractable Epilepsy, Malignant Glioma, Seizure Disorder, WHO Grade 2 Glioma, WHO Grade 3 Glioma

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm A (perampanel)
Arm Type
Experimental
Arm Description
Patients receive perampanel PO QD for 40 weeks in the absence of disease progression or unacceptable toxicity.
Arm Title
Arm B (ASD)
Arm Type
Active Comparator
Arm Description
Patients receive ASD per standard of care for 40 weeks in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
Anticonvulsant Agent
Other Intervention Name(s)
Anti-seizure agent, anticonvulsant, Anticonvulsant Agents, Anticonvulsants, antiepileptic, Antiepileptic Agent, Antiepileptics
Intervention Description
Given ASD
Intervention Type
Drug
Intervention Name(s)
Perampanel
Other Intervention Name(s)
E2007, Fycompa
Intervention Description
Given PO
Intervention Type
Other
Intervention Name(s)
Quality-of-Life Assessment
Other Intervention Name(s)
Quality of Life Assessment
Intervention Description
Ancillary studies
Intervention Type
Other
Intervention Name(s)
Questionnaire Administration
Intervention Description
Ancillary studies
Primary Outcome Measure Information:
Title
Number of Patients With a High-grade Glioma Who Achieve a > 50% Reduction in Focal Seizures With Perampanel (PER) 4 mg Daily After Failing 1 or More Anti-seizure Drugs (ASDs)
Description
Will compare seizure frequency before and 3 months after treatment with monotherapy and adjunctive PER and use descriptive statistics to demonstrate differences in responders. A P-value < 0.05 will be used to reflect statistical significance.
Time Frame
At 3 months
Title
Number of Patients With a High-grade Glioma Who Achieve a > 50% Reduction in Focal Seizures With PER 4 mg Daily After Failing 1 or More ASDs
Description
Will compare seizure frequency before and 6 months after treatment with monotherapy and adjunctive PER and use descriptive statistics to demonstrate differences in responders. A P-value < 0.05 will be used to reflect statistical significance.
Time Frame
At 6 months
Title
Number of Participants Alive at 3 Months With High-grade Glioma Treated With PER
Description
Chi-square and Student T-test will be used to measure differences in assessment and change during the study period.
Time Frame
At 3 months
Title
Decline in Neuropsychological Function
Description
Chi-square and Student T-test will be used to measure differences in assessment and change during the study period.
Time Frame
At 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subject, or the subject's legally acceptable representative is willing to participate in a clinical trial, provides written informed consent, and subject provides written assent, as required by the Mayo Clinic Institutional Review Board (IRB) policy involving human subjects. In the event of subject lacking the capacity or losing the ability to consent, consent will be deferred to subject's legally acceptable representative Subjects that meet the following diagnostic criteria: Patients with established clinical diagnoses of biopsy-proven high-grade glioma (grade II or above) and epilepsy refractory to at least 1, drug with a seizure frequency of at least 1 seizure episode per month prior to baseline visit Subjects with body weight of >= 40 kg and =< 125 kg at screening Adults age 18 and older Exclusion Criteria: Subject has serious cardiac, respiratory, renal, gastrointestinal, hematologic, or other medical condition as determined by the investigator to potentially interfere with the study Subjects with glioblastoma not following Stupp protocol for treatment of glioblastoma History of status epilepticus in the 6 months prior to screening or a history of seizure clusters progressing to status epilepticus Past medical history of drug and/or alcohol abuse Pregnant or breast-feeding Subjects treated with PER prior to baseline Prior felony conviction disclosed by the patient or previously stated in medical record History of violent behavior Clinically significant laboratory abnormality at screening or baseline visits, as determined by the investigators Use of an investigational drug or device within 20 days prior to treatment day 1 Repeated radiation therapy for tumor regrowth Subjects that plan to undergo tumor resection on or after baseline visit Uncontrolled psychiatric disorder at baseline Subjects who report active suicidal attempts or suicidality including subjects with a history of suicide attempts or suicidality determined to be clinically significant by investigators at screening
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
William Tatum
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic in Florida
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32224-9980
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Perampanel for the Reduction of Seizure Frequency in Patients With High-grade Glioma and Focal Epilepsy

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