“TREAT”ing seizures as an important endpoint
Year: 2025
Type: article
Abstract: Seizures are an important symptom in patients with glioma, particularly IDH mutant (IDHmt) low-grade gliomas (LGG). The incidence of seizures and intractable epilepsy in glioblastoma is approximately 40% and 15%; in grade 2 IDHmt gliomas more than two-thirds have seizures as an early symptom, and 41% have intractable epilepsy.1 Patients with LGG typically lack focal neurological deficits, and incompletely controlled seizures impact employment as well as personal responsibilities and pursuits. A recent systematic review2 of health-related quality of life (HRQoL) in low-grade glioma found, “Epilepsy/seizure burden was most consistently associated with worse HRQoL suggesting further seizure management, as a clinical priority, may ameliorate the impact of an LGG on patient HRQoL.” While the courses of LGG and tumor-related epilepsy control may diverge, they are nonetheless linked. There is a strong statistical association between seizure recurrence and tumor progression in previously controlled patients with LGG.3 Similarly, increasing evidence supports the hypothesis that successful antineoplastic treatment improves seizure control. Retrospective studies of radiotherapy and prospective studies of temozolomide have both demonstrated improved seizure control in LGG.4,5 The recent INDIGO trial in grade 2 gliomas provides additional suggestive evidence. Patients randomized to vorasidenib on average experienced slight tumor shrinkage, while those on placebo had tumor growth. Patients with seizures while receiving vorasidenib had substantially fewer seizures than those on placebo, and tumor volume correlated positively with seizure frequency in the combined population.6
Source: Neuro-Oncology
Authors: Mei-Yin Polley, David Schiff
Institutions: University of Chicago, University of Virginia
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4416228664