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Neuro-Oncology RESEARCH HIGHLIGHTS NEURO-ONCOLOGY Talampanel enhances survival in glioblastoma Talampanel, a glutamate receptor blocker, patients surviving for 2 years (41.7% CH3 can safely be added to the current versus 26.5%). This result was obtained O standard therapy for glioblastoma O despite the fact that fewer patients in the multiforme, concludes a new study N NABTT study had methylation of the involving 72 patients. Those treated MGMT gene promoter—a factor that was with talampanel showed no signs of O N recently shown to significantly influence CH3 toxicity, and their median survival and survival in glioblastoma multiforme. percentage survival at 24 months was “The NABTT patients were at higher encouraging compared with that observed risk to do poorly so the results are even in patients given standard treatment only. more compelling—but the effectiveness “We saw a significant improvement in of this agent and the therapeutic potential survival from this non-toxic, oral agent of the glutamate pathway must still be when administered in conjunction with NH2 confirmed in a phase III, randomized, radiation and temozolomide,” notes lead placebo-controlled trial. If this larger author Stuart Grossman. The 72 patients who were given study is positive, this would provide Talampanel blocks the AMPA receptor, a talampanel as part of their treatment confirmation that the glutamate pathway glutamate receptor that is present on both within the New Approaches to Brain is an important therapeutic target in neurons and glial cells. Gliomas tend to Tumor Therapy (NABTT) trial had a patients with glioblastoma,” comments produce excess glutamate, which is toxic to median overall survival of 18 months. The Grossman. Other agents that interfere nearby glia and neurons, and evidence is results from 60 patients aged between with the glutamatergic pathway exist, and accumulating that the glutamatergic system 18 and 70 years were compared with those future research is likely to focus on the stimulates the growth and migration obtained from patients in that age range toxicity and efficacy of these compounds, of gliomas, thereby enhancing disease from the European Organisation for as well as of combinations of agents that progression. Blocking glutamate receptors Research and Treatment of Cancer clinical target this pathway. in vitro and in animal models can halt trial, which compared radiotherapy alone Kathryn Senior glioma division and slow down invasion with radiotherapy plus temozolomide of surrounding tissues. “Preclinical data for the treatment of glioblastoms. Original article Grossman, S. A. et al. Talampanel with strongly suggest that the glutamate pathway Talampanel had marked effects both on standard radiation and temozolomide in patients with newly could be of importance in the treatment of median survival (20.3 months versus diagnosed glioblastoma: a multicenter phase II trial. J. Clin. Oncol. 27, 4155–4166 (2009). glioblastoma,” notes Grossman. 14.6 months) and on the percentage of NATURE REVIEWS | NEUROLOGY VOLUME 5 | OCTOBER 2009 | 521 © 2009 Macmillan Publishers Limited. All rights reserved.
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