F Mo1, S Meletti2,3, V Belcastro4, S Quadri5, M Napolitano6, L Bello7, F Dainese8, M Scarpelli9, I Florindo10, A Mascia11, G Pauletto12, F Bruno13, A Pellerino13, G Giovannini2,14, M Polosa15, M Sessa5, M Conti Nibali7, G Di Gennaro11, G L Gigli16,17, A Pisanello18, F Cavallieri14,18, R Rudà13,19. 1. Division of Neuro-Oncology, Dept. Neuroscience, University and City of Health and Science Hospital, Via Cherasco 15, 10126, Torino, Italy. francy.mo91@gmail.com. 2. Division of Neurology, Modena University Hospital, Modena, Italy. 3. Center for Neuroscience and Neurotechnology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. 4. Division of Neurology, Maggiore Hospital, Lodi, Italy. 5. Division of Neurology, ASST Papa Giovanni XXIII of Bergamo, Bergamo, Italy. 6. Division of Neurology and Stroke Unit, Hospital A. Cardarelli, Napoli, Italy. 7. Division of Neurosurgical Oncology, Department of Oncology and Hemato-Oncology, Università Degli Studi Di Milano, Milan, Italy. 8. Division of Neurology, Epilepsy Centre, Hospital of Venezia, Venice, Italy. 9. Division of Neurology, Department of Neuroscience, AOUI Verona, Verona, Italy. 10. Division of Neurology, Hospital of Parma, Parma, Italy. 11. IRCCS Neuromed, Pozzilli, Italy. 12. Neurology Unit, Department of Neuroscience, "S. Maria Della Misericordia" University Hospital, Udine, Italy. 13. Division of Neuro-Oncology, Dept. Neuroscience, University and City of Health and Science Hospital, Via Cherasco 15, 10126, Torino, Italy. 14. Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy. 15. Division of Neurosurgery, ASST Lariana, Como, Italy. 16. Department of Medicine (DAME), University of Udine, Udine, Italy. 17. Clinical Neurology Unit, "S. Maria Della Misericordia" University Hospital, Udine, Italy. 18. Neurology Unit, Neuromotor & Rehabilitation Department, Azienda USL-IRCCS Di Reggio Emilia, Reggio Emilia, Italy. 19. Division of Neurology, San Giacomo Hospital, AULSS2 Marca Trevigiana (TV), Treviso, Italy.
Abstract
PURPOSE: Lacosamide (LCM) is a third-generation anti-seizure medication (ASM) approved for focal onset epilepsy in patients aged ≥ 4.378 Previous studies have reported an efficacy of LCM as add-on treatment in brain tumor-related epilepsy (BTRE). To date, there are no studies in the literature focusing on lacosamide used in monotherapy to treat BTRE. In our retrospective study we investigated efficacy and tolerability of LCM in monotherapy in a multicenter national cohort of primary brain tumor patients. METHODS: We collected from 12 Italian Centers 132 patients with primary brain tumors who were treated with LCM in monotherapy. For each patient we evaluated seizure freedom at 3 and 6 months (primary endpoints), side effects and drop-out rate (secondary endpoints). RESULTS: Overall, LCM led to seizure freedom in 64.4% of patients at 3 months and 55% at 6 months. Patients who used two or more ASMs before LCM had a worse seizure control than patients in monotherapy with LCM as first choice. In 14 patients, we observed seizure control despite tumor progression on magnetic resonance (MRI). Multivariate analysis showed that gross-total resection at diagnosis was significantly associated with higher seizure freedom rate at 6 months. Side effects were mainly mild (grade 1-2 according to CTCAE classification) and drop-out rate was low (1.5%). Main side effects were dizziness and somnolence. CONCLUSIONS: This is the first study showing a good efficacy and tolerability of LCM when used in monotherapy in BTRE. Further prospective studies are needed to confirm these preliminary data, investigating also quality of life and neurocognitive functions.
PURPOSE: Lacosamide (LCM) is a third-generation anti-seizure medication (ASM) approved for focal onset epilepsy in patients aged ≥ 4.378 Previous studies have reported an efficacy of LCM as add-on treatment in brain tumor-related epilepsy (BTRE). To date, there are no studies in the literature focusing on lacosamide used in monotherapy to treat BTRE. In our retrospective study we investigated efficacy and tolerability of LCM in monotherapy in a multicenter national cohort of primary brain tumor patients. METHODS: We collected from 12 Italian Centers 132 patients with primary brain tumors who were treated with LCM in monotherapy. For each patient we evaluated seizure freedom at 3 and 6 months (primary endpoints), side effects and drop-out rate (secondary endpoints). RESULTS: Overall, LCM led to seizure freedom in 64.4% of patients at 3 months and 55% at 6 months. Patients who used two or more ASMs before LCM had a worse seizure control than patients in monotherapy with LCM as first choice. In 14 patients, we observed seizure control despite tumor progression on magnetic resonance (MRI). Multivariate analysis showed that gross-total resection at diagnosis was significantly associated with higher seizure freedom rate at 6 months. Side effects were mainly mild (grade 1-2 according to CTCAE classification) and drop-out rate was low (1.5%). Main side effects were dizziness and somnolence. CONCLUSIONS: This is the first study showing a good efficacy and tolerability of LCM when used in monotherapy in BTRE. Further prospective studies are needed to confirm these preliminary data, investigating also quality of life and neurocognitive functions.
Authors: Vicente Villanueva; Rosana Saiz-Diaz; Manuel Toledo; Ana Piera; Jose Angel Mauri; Juan Jesús Rodriguez-Uranga; Francisco Javier López-González; Asier Gómez-Ibáñez; Mercedes Garcés; Jesús González de la Aleja; Xiana Rodríguez-Osorio; Susana Palao-Duarte; Ascensión Castillo; Macarena Bonet; Jesús Ruiz-Giménez; Juan Palau; Alberto Arcediano; Maria Toledo; Ana Gago Journal: Epilepsy Behav Date: 2016-11-16 Impact factor: 2.937
Authors: Marlon G Saria; Courtney Corle; Jethro Hu; Jeremy D Rudnick; Surasak Phuphanich; Maciej M Mrugala; Laura K Crew; Daniela A Bota; Beverly Dan Fu; Ryan Y Kim; Tiffany Brown; Homira Feely; Joanne Brechlin; Bradley D Brown; Jan Drappatz; Patrick Y Wen; Clark C Chen; Bob Carter; Jong Woo Lee; Santosh Kesari Journal: J Neurosurg Date: 2013-03-01 Impact factor: 5.115