PCSM-08EFFICACY AND TOLERABILITY OF LACOSAMIDE IN PATIENTS WITH GLIOMA AND SEIZURES: A PROSPECTIVE STUDY

BACKGROUND: Lacosamide (LCM) has been suggested to improve seizure control as add-on treatment in brain tumor patients. We present the results of a prospective study on the efficacy and tolerability of LCM in a cohort of patients with low (LGG) and high grade (HGG) gliomas with active epilepsy, either on chemotherapy or radiotherapy or during observation alone with MRI. METHODS: We enrolled 62 adult patients with persisting seizures (seizures u003e 1 per month) despite an adequate treatment with other antiepileptic drugs. The endpoints of the study were a significant reduction of seizure frequency (u003e 50% compared with baseline) and seizure freedom (SF) at 3 and 6 months, being concomitant AEDs and steroids unchanged or reduced. RESULTS: Among grade II gliomas a significant reduction of seizures was observed in 5/22 patients (22.7.%) and 7/22 (36.8%) at 3 and 6 months after start of LCM, respectively; a SF was obtained in 6/22 (23.3%) and 8/22 (42.1%) at 3 and 6 months after start of LCM, respectively. Among HGG a significant reduction of seizures was obtained in 10/41 patients (24.4%) and 7/33 patients (21.1%) at 3 and 6 months after start of LCM, respectively; a SF was obtained in 19/40 (47.5%) and 15/40 (45.5%) at 3 and 6 months after the start of LCM, respectively. Four out of 11 and 7/15 patients with LGG who responded to LCM did not receive any antineoplastic treatment, whereas 18/40 patients with HGG had the tumor stable or responding on MRI (RANO criteria) following antineoplastic treatment. A resolution of a status epilepticus was obtained in 7 patients. In 2 cases only LCM was withdrawn due to dizziness and fatigue or resistant seizures. CONCLUSIONS: This is the first prospective study showing a significant activity of LCM as add-on therapy in gliomas with different grades of malignancy.