Retrospective analysis of the tolerability and activity of lacosamide in patients with brain tumors

Clinical article

Marlon G. Saria R.N.1, Courtney Corle M.P.H.1, Jethro Hu M.D.2, Jeremy D. Rudnick M.D.2, Surasak Phuphanich M.D.2, Maciej M. Mrugala M.D., Ph.D.3,5, Laura K. Crew N.P.4,5, Daniela A. Bota M.D., Ph.D.6,7,8, Beverly Dan Fu N.P.6, Ryan Y. Kim B.A.1, Tiffany Brown P.A.1, Homira Feely N.P.1,9, Joanne Brechlin M.B.A., M.P.H.1, Bradley D. Brown B.A.1, Jan Drappatz M.D.10,11, Patrick Y. Wen M.D.10,11, Clark C. Chen M.D., Ph.D.9, Bob Carter M.D., Ph.D.9, Jong Woo Lee M.D., Ph.D.10, and Santosh Kesari M.D., Ph.D.1
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  • 1 Departments of Neurosciences and
  • | 9 Neurosurgery, Moores Cancer Center, University of California, San Diego, La Jolla;
  • | 2 Cochran Brain Tumor Center, Department of Neurology and Neurosurgery, Cedars-Sinai Medical Center, Los Angeles;
  • | 6 Departments of Neurology and
  • | 7 Neurological Surgery, and
  • | 8 Chao Family Comprehensive Cancer Center, School of Medicine, University of California, Irvine, California;
  • | 3 Departments of Neurology and
  • | 4 Neurological Surgery, and
  • | 5 Neuro-Oncology Center, University of Washington School of Medicine, Seattle, Washington;
  • | 10 Department of Neurology, Brigham and Women's Hospital; and
  • | 11 Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
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Object

The object of this study was to determine the tolerability and activity of lacosamide in patients with brain tumors.

Methods

The authors reviewed the medical records at 5 US academic medical centers with tertiary brain tumor programs, seeking all patients in whom a primary brain tumor had been diagnosed and who were taking lacosamide.

Results

The authors identified 70 patients with primary brain tumors and reviewed seizure frequency and toxicities. The majority of the patients had gliomas (96%). Fifty-five (78%) had partial seizures only, and 12 (17%) had generalized seizures. Most of the patients (74%) were started on lacosamide because of recurrent seizures. Forty-six patients (66%) reported a decrease in seizure frequency, and 21 patients (30%) reported stable seizures. Most of the patients (54 [77%]) placed on lacosamide did not report any toxicities.

Conclusions

This retrospective analysis demonstrated that lacosamide was both well tolerated and active as an add-on antiepileptic drug (AED) in patients with brain tumors. Lacosamide's novel mechanism of action will allow for concurrent use with other AEDs, as documented by its activity across many different types of AEDs used in this patient population. Larger prospective studies are warranted.

Abbreviations used in this paper:

AED = antiepileptic drug; EIAED = enzyme-inducing AED; NEIAED = nonenzyme-inducing AED.

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JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

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