P17.48 * SURVIVAL BENEFIT OF LEVETIRACETAM IN GLIOBLASTOMA: A PROSPECTIVE SINGLE-CENTER STUDY

Abstract

OBJECTIVE: A chemo-sensitizing effect of levetiracetam (LEV) has been suggested because LEV inhibits O-6-methylguanine-DNA methyltransferase (MGMT). However, the survival benefit of LEV has not been clinically documented. This study was performed to assess the survival benefit of LEV as a chemo-sensitizer of temozolomide for glioblastoma patients compared to other anti-epileptic drugs (AEDs). METHODS: A total of 46 consecutive patients with primary supratentorial glioblastoma who were treated with concomitant chemoradiotherapy and adjuvant temozolomide therapy with LEV were prospectively enrolled. Forty-four consecutive patients with the same condition who had not taken LEV during identical chemoradiotherapy were selected as the control group. Gender, age, extent of lesion, the Karnofsky performance scale (KPS) score, extent of removal, and methylation status of the MGMT promoter were not significantly different between the LEV group and the control group. RESULTS: The median progression-free and overall survival (PFS and OS, respectively) of the LEV group (10.8 months [95% CI, 8.3-13.3] and 25.7 months [95% CI, 21.0-30.4], respectively) were significantly longer than those of the control group (6.6 months [95% CI, 5.2-8.0] and 16.8 [95% CI, 12.2-21.4], respectively) (p = 0.017 and 0.035, respectively). Significant prognostic factors for OS of all 90 patients were the preoperative KPS score (p = 0.027; HR = 0.360), methylation status of the MGMT promoter (p = 0.002; HR = 0.203), and LEV (p = 0.004; HR = 0.244) in multivariate analysis. CONCLUSIONS: LEV may provide a survival benefit in glioblastoma patients who receive temozolomide-based chemotherapy compared with other AEDs. A prospective randomized study may be indicated.