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Abstract Details

Temozolomide does not meaningfully reduce seizure frequency in elderly glioblastoma patients
Neuro-oncology
P2 - Poster Session 2 (8:00 AM-9:00 AM)
13-004
To determine, using randomized controlled data, whether temozolomide has any effect on seizure outcomes in elderly glioblastoma patients.
There is accumulating evidence that temozolomide can reduce seizure frequency in patients with low grade glioma. Less is known about seizure control in high grade glioma. Prior to 2017, it was not known if the addition of temozolomide to radiation therapy provided benefit to elderly glioblastoma patients. The CE6 trial (Perry, 2017) randomized 562 glioblastoma patients aged 65 or older to short-course (3 weeks) radiotherapy with or without temozolomide and found that temozolomide conferred a survival benefit. Seizure outcomes have not yet been reported from this clinical trial, but some seizure data were recorded.
We performed an unplanned secondary analysis of the CE6 data. The randomized trial design has been previously reported. Seizures were recorded by clinicians as adverse events and by patients in quality of life questionnaires. A Chi-square test of seizure rates between the two groups (α=0.05) and a Kaplan–Meier estimator of time-to-first self-reported seizure were planned.
Almost all patients were followed until they died. In the radiotherapy alone group, 68 patients (24%) had a documented or self-reported seizure versus 83 patients (30%) in the temozolomide plus radiotherapy group, Chi-square analysis showed no difference (p=0.15). The Kaplan–Meier analysis of time to first self-reported seizure showed no difference between groups (log-rank p=0.054). The rates of self-reported seizure were 23% in the radiotherapy alone group and 20% in the temozolomide plus radiotherapy group. Two patients in the temozolomide group died of seizures.
This study was not powered to detect differences in seizure outcomes, but temozolomide had minimal effect on seizure control in elderly patients with glioblastoma. Randomized controlled data can best determine whether or not temozolomide has an anti-seizure effect and similar analyses of low grade glioma trials will be important.
Authors/Disclosures
Seth A. Climans, MD (London Health Sciences Centre)
PRESENTER 		Dr. Climans has nothing to disclose.
No disclosure on file
J G. Cairncross, MD, FÂ鶹´«Ã½Ó³»­ (University of Calgary) No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
James R. Perry, MD, FRCP(C), FÂ鶹´«Ã½Ó³»­ (Sunnybrook Health Science Center) The institution of Dr. Perry has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Enveric Biosciences . The institution of Dr. Perry has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Servier. The institution of Dr. Perry has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novocure. Dr. Perry has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Canadian Brain Tumour Consortium. Dr. Perry has stock in Synaptive Medical.
No disclosure on file
No disclosure on file
No disclosure on file
Warren P. Mason, MD, FÂ鶹´«Ã½Ó³»­ (Princess Margaret cancer Centre) Dr. Mason has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novocure. Dr. Mason has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Mason has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Servier. Dr. Mason has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boeringher Ingelheim. Dr. Mason has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ono Therapeutics.