Epilepsy is a common symptom in patients with glioblastoma (Gb). Levetiracetam (LEV), an antiepileptic drug (AED), enhances MGMT inhibition and reduces chemotherapy mediated neuronal toxicity, offering a theoretical benefit over other AEDs.
213 Hispanic patients were included. All patients underwent surgery (if feasible) followed by chemoradiation based on temozolomide. Type of AED was selected under treating physician discretion. Recorded variables included demographics, AED, dosage, MGMT status, performance status (PS) and type of surgical intervention. The relationship between overall survival (OS), AED and MGMT methylation status was explored.
Mean age was 53-yo (SD+/-14.7), 56.8% were male, 73% presented with epilepsy after diagnosis and 50.7% harbored methylated MGMT (metMGMT). 41% were treated with LEV, 26% were given another AED and 33% did not require any AED. AED indication was not associated with age (p = 0.087), PS (p = 0.78) anatomic tumor site (p = 0.34) or MGMT status (p = 0.98). Median OS was 25.8 months (95%CI 21.6-31.5), 27.9 months (95%CI 23.8-33.7) for those with metMGMT, and 11.83 months (95%CI 7.73-16.67) for non-metMGMT (p
Retrospective analysis of this cohort suggests that LEV modifies OS in non-metMGMT Gb patients making it comparable to those with metMGMT. Further validation of this data in clinical trials is warranted.
Clinical trial identification
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All authors have declared no conflicts of interest.