Levetiracetam and valproic acid in glioma: antiseizure and potential antineoplastic effects.

IF 3 4区医学 Q2 ONCOLOGY Future oncology Pub Date : 2025-02-01 Epub Date: 2025-01-09 DOI:10.1080/14796694.2025.2450215

Bobak F Khalili, Tobias Walbert, Craig Horbinski, Karan Dixit, Kapil Gururangan, Helen Thio, Matthew C Tate, Roger Stupp, Rimas V Lukas, Jessica W Templer

{"title":"Levetiracetam and valproic acid in glioma: antiseizure and potential antineoplastic effects.","authors":"Bobak F Khalili, Tobias Walbert, Craig Horbinski, Karan Dixit, Kapil Gururangan, Helen Thio, Matthew C Tate, Roger Stupp, Rimas V Lukas, Jessica W Templer","doi":"10.1080/14796694.2025.2450215","DOIUrl":null,"url":null,"abstract":"Seizures are a frequent complication in glioma. Incidence of brain tumor-related epilepsy (BTRE) in high-grade glioma (HGG) is an estimated > 25% and in low-grade glioma (LGG) is approximately 72%. Two first-line antiseizure medications (ASMs) for BTRE include levetiracetam (LEV) and valproic acid (VPA). Use of VPA has decreased because of a broader side effect profile, potential interaction with chemotherapeutic drugs, and availability of newer generation agents. In refractory BTRE, LEV and VPA may be prescribed together to enhance seizure control. VPA and LEV have gained attention for their purported antineoplastic effects and synergistic role with temozolomide. VPA is suggested to modulate anticancer activity in vitro through multiple mechanisms. In addition, retrospective studies indicate increased overall survival in patients with epileptogenic HGGs who are managed with LEV or VPA rather than other ASMs. However, these studies have numerous limitations. It is also reported that patients with glioma and a seizure history have a longer survival. This extended survival, if one exists, may be only observed in certain gliomas with corresponding patient characteristics. We provide a brief overview of the management of BTRE, VPA and LEV as anticonvulsants and antineoplastics, and the factors that may be associated with survival in epileptogenic glioma.","PeriodicalId":12672,"journal":{"name":"Future oncology","volume":" ","pages":"483-491"},"PeriodicalIF":3.0000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812422/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Future oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/14796694.2025.2450215","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/9 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Seizures are a frequent complication in glioma. Incidence of brain tumor-related epilepsy (BTRE) in high-grade glioma (HGG) is an estimated > 25% and in low-grade glioma (LGG) is approximately 72%. Two first-line antiseizure medications (ASMs) for BTRE include levetiracetam (LEV) and valproic acid (VPA). Use of VPA has decreased because of a broader side effect profile, potential interaction with chemotherapeutic drugs, and availability of newer generation agents. In refractory BTRE, LEV and VPA may be prescribed together to enhance seizure control. VPA and LEV have gained attention for their purported antineoplastic effects and synergistic role with temozolomide. VPA is suggested to modulate anticancer activity in vitro through multiple mechanisms. In addition, retrospective studies indicate increased overall survival in patients with epileptogenic HGGs who are managed with LEV or VPA rather than other ASMs. However, these studies have numerous limitations. It is also reported that patients with glioma and a seizure history have a longer survival. This extended survival, if one exists, may be only observed in certain gliomas with corresponding patient characteristics. We provide a brief overview of the management of BTRE, VPA and LEV as anticonvulsants and antineoplastics, and the factors that may be associated with survival in epileptogenic glioma.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

左乙曲坦和丙戊酸在胶质瘤中的作用：抗癫痫和潜在的抗肿瘤作用。

癫痫是神经胶质瘤的常见并发症。脑肿瘤相关癫痫（BTRE）在高级别胶质瘤（HGG）中的发病率估计为25%，在低级别胶质瘤（LGG）中约为72%。治疗BTRE的两种一线抗癫痫药物包括左乙拉西坦（LEV）和丙戊酸（VPA）。由于更广泛的副作用、与化疗药物的潜在相互作用以及新一代药物的可用性，VPA的使用已经减少。在难治性BTRE中，LEV和VPA可同时使用以加强癫痫发作的控制。VPA和LEV因其抗肿瘤作用和与替莫唑胺的协同作用而受到关注。VPA可能通过多种机制调节体外抗肿瘤活性。此外，回顾性研究表明，与其他asm相比，LEV或VPA治疗癫痫性hgg患者的总生存率更高。然而，这些研究有许多局限性。也有报道称，有神经胶质瘤和癫痫发作史的患者有较长的生存期。这种延长的生存期，如果存在的话，可能只在某些具有相应患者特征的胶质瘤中观察到。我们简要概述了BTRE， VPA和LEV作为抗惊厥药和抗肿瘤药的管理，以及可能与癫痫性胶质瘤存活相关的因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Future oncology ONCOLOGY-

CiteScore

5.40

自引率

3.00%

发文量

335

审稿时长

4-8 weeks

期刊介绍： Future Oncology (ISSN 1479-6694) provides a forum for a new era of cancer care. The journal focuses on the most important advances and highlights their relevance in the clinical setting. Furthermore, Future Oncology delivers essential information in concise, at-a-glance article formats - vital in delivering information to an increasingly time-constrained community. The journal takes a forward-looking stance toward the scientific and clinical issues, together with the economic and policy issues that confront us in this new era of cancer care. The journal includes literature awareness such as the latest developments in radiotherapy and immunotherapy, concise commentary and analysis, and full review articles all of which provide key findings, translational to the clinical setting.