沃拉西尼抑制异柠檬酸脱氢酶后早期癫痫发作自由与[18F]氟多巴正电子发射断层扫描反应:1例报告。

IF 6.6 1区 医学 Q1 CLINICAL NEUROLOGY
Epilepsia Pub Date : 2025-08-06 DOI:10.1111/epi.18593
Roberta Rudà, Francesco Bruno, Alessia Pellerino, Edoardo Pronello, Michela Zotta, Silvia Morbelli
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引用次数: 0

摘要

Vorasidenib是一种双重异柠檬酸脱氢酶1/2 (IDH1/2)抑制剂,在延长idh突变2级胶质瘤的无进展生存期和下一次干预时间方面显示出卓越的疗效。该病例是一项正在进行的机构研究的一部分,该研究旨在探索vorasidenib对癫痫发作控制的影响,以及[18F]氟多巴(F-DOPA)正电子发射断层扫描(PET)比磁共振成像(MRI)更早检测治疗反应的潜力。一名52岁的2级idh突变1p19q编码少突胶质细胞瘤患者,术后持续癫痫发作,接受了沃拉西尼治疗。从治疗的第一个月起,患者实现了早期癫痫发作的自由,抗癫痫药物(ASM)没有任何变化。在治疗后3个月和6个月,MRI显示病情稳定(肿瘤体积轻微进行性缩小),而F-DOPA PET显示从第3个月开始示踪剂摄取明显减少,6个月时证实,根据神经肿瘤学1.0标准PET反应评估,对应部分缓解。这是首次报道idh突变2级胶质瘤患者在沃拉西尼治疗后获得早期癫痫控制和F-DOPA PET代谢反应。它强调了vorasidenib在癫痫发作管理方面的潜力,以及F-DOPA PET在早期治疗评估中的价值。需要进一步的研究来评估使用vorasidenib治疗的idh突变型低级别胶质瘤的长期癫痫发作控制和ASM的潜在减少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early seizure freedom with [18F]fluorodopa positron emission tomography response after isocitrate dehydrogenase inhibition with vorasidenib: First case report.

Vorasidenib, a dual isocitrate dehydrogenase 1/2 (IDH1/2) inhibitor, showed superior efficacy in prolonging progression-free survival and time to next intervention in IDH-mutant grade 2 gliomas. This case is part of an ongoing institutional study exploring the impact of vorasidenib on seizure control and the potential of [18F]fluorodopa (F-DOPA) positron emission tomography (PET) to detect treatment response earlier than magnetic resonance imaging (MRI). A 52-year-old patient with grade 2 IDH-mutant 1p19q-codeleted oligodendroglioma and persistent postoperative seizures received vorasidenib. He achieved early seizure freedom from the first month of therapy without any change of antiseizure medication (ASM). At 3 and 6 months after treatment, MRI showed stable disease (with a slight progressive reduction in tumor volume), whereas F-DOPA PET revealed a significant decrease in tracer uptake starting from the third month, which was confirmed at 6 months, corresponding to a partial response according to PET Response Assessment in Neuro-Oncology 1.0 criteria. This is the first report of an IDH-mutant grade 2 glioma patient achieving early seizure control and metabolic response on F-DOPA PET after vorasidenib. It highlights the potential of vorasidenib for seizure management and the value of F-DOPA PET for early treatment assessment. Further studies are required to evaluate long-term seizure control and potential reduction of ASM in IDH-mutant low-grade gliomas treated with vorasidenib.

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来源期刊
Epilepsia
Epilepsia 医学-临床神经学
CiteScore
10.90
自引率
10.70%
发文量
319
审稿时长
2-4 weeks
期刊介绍: Epilepsia is the leading, authoritative source for innovative clinical and basic science research for all aspects of epilepsy and seizures. In addition, Epilepsia publishes critical reviews, opinion pieces, and guidelines that foster understanding and aim to improve the diagnosis and treatment of people with seizures and epilepsy.
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