Glioblastoma, known as one of the most aggressive brain tumors, generally comes with a poor prognosis. However, new research indicates that certain pain relief medications might enhance survival rates for patients.
A study conducted by researchers at Mass General Brigham revealed that an existing medication regimen—including gabapentin, both a painkiller and an anti-seizure drug—was correlated with better outcomes in glioblastoma patients. The findings were shared in a recent issue of Nature Communications.
Motivated by earlier studies on mice that hinted at gabapentin’s potential to affect tumors, the research team analyzed outcomes from nearly 700 glioblastoma patients. Many were using gabapentin primarily to manage neuralgia, as noted in a press release from MGB.
Interestingly, those who took the drug had a survival time averaging 16 months, which the researchers deemed “statistically significant.” Dr. Joshua Byrnestock, the lead author of the study and a clinical fellow at Mass General, emphasized that the goal was to explore new avenues within cancer neuroscience and to consider innovative strategies to target this evolving type of tumor.
Byrnestock expressed surprise at the positive survival benefits. “It’s always remarkable to see a hypothesis come to fruition,” he remarked. The study also noted a decrease in serum TSP-1 levels among patients—a potential biomarker for treatment response.
After these preliminary results, Byrnestock reached out to the University of California, San Francisco (UCSF) to conduct further investigations with their glioblastoma patients. The findings mirrored those of the initial study: patients on gabapentin had an average survival of 20.8 months, compared to 14.7 months for those not on the treatment.
Overall, across both study cohorts totaling 1,072 patients, the use of gabapentin consistently linked to a significant improvement in survival, as Byrnestock pointed out. Furthermore, low levels of TSP-1 were also observed in the gabapentin group, hinting at areas needing more investigation.
Byrnestock noted a lack of progress in survival rates for GBM patients since the early 2000s, underscoring the need for more creative approaches to understanding and treating these tumors.
Understanding Gabapentin
The FDA first approved gabapentin in December 1993 for adult seizure disorders, later extending its approval for use in children in 2000. By 2002, it was cleared for treating post-herpetic neuralgia, although it’s often used off-label for various pain conditions.
Common side effects associated with gabapentin include fatigue, dizziness, nausea, and weight gain, among others. Patients are advised to consult their healthcare provider about any severe or persistent side effects.
Limitations and Future Directions
This study does have its limitations, being largely retrospective and uncontrolled. As Byrnestock pointed out, while promising, the study didn’t administer gabapentin in a randomized manner, so this requires some caution. Larger clinical trials will be necessary to validate the findings and examine the roles of gabapentin and TSP-1 in glioblastoma further.
Byrnestock remains “cautiously optimistic” about the results. While gabapentin is FDA-approved and generally well-received, he insists that changes to clinical practices shouldn’t be made based solely on this initial study without more controlled trials. He acknowledges that gabapentin may be a viable option for treating GBM patients who experience neuropathic pain or seizures following surgery.
Described as “a ruthless, progressive, universally fatal disease,” glioblastoma affects around 14,500 Americans every year, with a dismal five-year survival rate of only 6.9%.
