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Efficacy and safety of Levetiracetam vs. other antiepileptic drugs in Hispanic patients with glioblastoma

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Abstract

Epilepsy is a common symptom in patients with glioblastoma (GB). 213 patients with GB from RedLANO follow-up registry were included. All patients underwent surgery, if feasible, followed by chemoradiation based on temozolomide (Stupp platform). Information was recorded regarding demographics, seizure timing, anti-epileptic drugs (AEDs), dosage, time to next seizure, total seizures in 6 months, and main side effects of AEDs. The relationship between epilepsy treatment and overall survival (OS) was evaluated. Mean age was 53 years old and 56.8% were male. Seventy-eight patients (37%) were treated with levetiracetam (LEV), 27% were given another AED and 36% did not require any AED. Choice of AED was not associated with age (p = 0.67), performance status (p = 0.24) or anatomic tumor site (p = 0.34). Seizures and AED requirement were greater in those having primary GB (p = 0.04). After starting an AED, the mean time until next crisis was 9.9 days (SD ± 6.3), which was shorter in those receiving LEV (p = 0.03); mean number of seizures during the first 3 and 6 months were 2.9 and 4, respectively. Most patients treated with LEV (n = 46) required less than two medication adjustments compared to those treated with other AEDs (p = 0.02). Likewise, less patients exposed to LEV required a coadjuvant drug (p = 0.04). Additionally, patients receiving LEV had significantly less adverse effects compared to patients treated with another AED. OS was significantly higher in the group treated with LEV compared to other AEDs (25.5 vs. 17.9 months; p = 0.047). Patients treated with LEV had better seizure control and longer OS compared to other AEDs.

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Funding

The study received financial funding from an independent grant from the Foundation for Clinical and Applied Cancer Research (FICMAC -2013-009).

Author information

Author notes

  1. Andrés F. Cardona, Leonardo Rojas, Beatriz Wills and Alejandro Ruiz-Patiño have contributed equally to this work.

Authors and Affiliations

  1. Brain Tumors Unit, Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia

    Andrés F. Cardona, Hernán Carranza, Carlos Vargas, Jorge Otero, Sandra Franco & Carlos Ortíz

  2. Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 – 72, c. 318, Bogotá, Colombia

    Andrés F. Cardona, Beatriz Wills, Hernán Carranza, Carlos Vargas & Jorge Otero

  3. Latin American Neuro-Oncology Network (RedLANO), Bogotá, Colombia

    Andrés F. Cardona & León Darío Ortíz

  4. Clinical Oncology Department, Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia

    Leonardo Rojas

  5. Internal Medicine Department, Hospital Universitario San Ignacio, Bogotá, Colombia

    Laura Bernal

  6. Medicine Faculty, Pontificia Universidad Javeriana, Bogotá, Colombia

    Alejandro Ruiz-Patiño

  7. Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), México City, Mexico

    Oscar Arrieta & Zyanya Lucia Zatarain-Barrón

  8. Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia

    Enrique Jiménez Hakim, Fernando Hakim & Juan Armando Mejía

  9. Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia

    Enrique Jiménez Hakim, Fernando Hakim, Juan Armando Mejía, Nicolás Useche & Sonia Bermúdez

  10. Radiology Department, Neuro-radiology Section, Fundación Santa Fe de Bogotá, Bogotá, Colombia

    Nicolás Useche & Sonia Bermúdez

  11. Neurology Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia

    Luis Carlos Mayor

  12. Neuro-Oncology Unit, Clinical Oncology Department, Clínica de Las Américas, Medellín, Colombia

    León Darío Ortíz

  13. Medical Oncology Service, Catalan Institute of Oncology, Hospital Duran I Reynals - IDIBELL, Hospitalet de Llobregat, Spain

    Miguel Gil-Gil

  14. Medical Oncology Service, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, IGTP, Badalona, Spain

    Carmen Balaña

Authors
  1. Andrés F. Cardona
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  2. Leonardo Rojas
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  3. Beatriz Wills
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  4. Laura Bernal
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  5. Alejandro Ruiz-Patiño
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  6. Oscar Arrieta
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  7. Enrique Jiménez Hakim
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  18. Carlos Ortíz
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  19. Miguel Gil-Gil
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  20. Carmen Balaña
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  21. Zyanya Lucia Zatarain-Barrón
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Corresponding author

Correspondence to Andrés F. Cardona.

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Conflict of interest

Andrés F. Cardona has received Consulting fees or honorarium and payment for lectures including service on speakers’ bureaus from Roche, Pfizer, Bristol Myers Squib, Merck, MSD and Astra Zeneca. The other authors declare thay have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Cardona, A.F., Rojas, L., Wills, B. et al. Efficacy and safety of Levetiracetam vs. other antiepileptic drugs in Hispanic patients with glioblastoma. J Neurooncol 136, 363–371 (2018). https://doi.org/10.1007/s11060-017-2660-0

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  • DOI: https://doi.org/10.1007/s11060-017-2660-0

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