ArticleNeurology2009
Correlation of enzyme-inducing anticonvulsant use with outcome of patients with glioblastoma.
Article in Neurology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 88 citations in OpenAlex.
- Management of epilepsy in brain tumors.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2019Guideline
- Quantification of the impact of enzyme-inducing antiepileptic drugs on irinotecan pharmacokinetics and SN-38 exposure.Journal of clinical pharmacology · 2015Trial
- Prolonged survival with valproic acid use in the EORTC/NCIC temozolomide trial for glioblastoma.Neurology · 2011Trial
- Association between Levetiracetam Use and Survival in Patients with Glioblastoma: A Nationwide Population-Based Study.Cancer research and treatment · 2025Article
- Efficacy of antiepileptic drugs in glioma patients with epilepsy: a systematic review.Neuro-oncology practice · 2021Review
- Epilepsy in brain metastasis: an emerging entity.Current treatment options in neurology · 2020Review
- Choice of antiepileptic drugs affects the outcome in cancer patients with seizures.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2018Article
- Lacosamide in patients with gliomas and uncontrolled seizures: results from an observational study.Journal of neuro-oncology · 2018Observational
- Efficacy and safety of Levetiracetam vs. other antiepileptic drugs in Hispanic patients with glioblastoma.Journal of neuro-oncology · 2018Article
- In vitro antineoplastic effects of brivaracetam and lacosamide on human glioma cells.Journal of experimental & clinical cancer research : CR · 2017Article
- Does the choice of antiepileptic drug affect survival in glioblastoma patients?Journal of neuro-oncology · 2016Article
- Prognostic relevance of epilepsy at presentation in glioblastoma patients.Neuro-oncology · 2016Article
- Does Valproic Acid or Levetiracetam Improve Survival in Glioblastoma? A Pooled Analysis of Prospective Clinical Trials in Newly Diagnosed Glioblastoma.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2016Article
- Repurposing some older drugs that cross the blood-brain barrier and have potential anticancer activity to provide new treatment options for glioblastoma.British journal of clinical pharmacology · 2016Review
- Article
- Epilepsy and brain tumors.Handbook of clinical neurology · 2016Review
- Risk factors for seizures and antiepileptic drug-associated adverse effects in high-grade glioma patients: A multicentre, retrospective study in Hong Kong.Surgical practice · 2015Article
- Treatment of epileptic seizures in brain tumors: a critical review.Neurosurgical review · 2014Review
- Seizure prognosis in brain tumors: new insights and evidence-based management.The oncologist · 2014Review
- Tumor associated seizures in glioblastomas are influenced by survival gene expression in a region-specific manner: a gene expression imaging study.Epilepsy research · 2014Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundClinical trials involving patients with glioblastoma (GBM) distinguish cohorts who are treated with enzyme-inducing anticonvulsants (EIAC). Such anticonvulsants induce hepatic P450 microsomal enzymes, which accelerate the metabolism of certain chemotherapy and molecular targeted agents. However, the resultant effect of such induction on patient outcome has received limited study.
methodsWe performed a correlative analysis of baseline EIAC use with outcome, using a cross-sectional database of 620 patients with newly diagnosed GBM treated prospectively on North Central Cancer Treatment Group trials.
resultsAt registration, 72% were receiving treatment with EIAC; 2% were receiving non-EIACs, and the 26% were not receiving anticonvulsants (26%). Surprisingly, in the multivariable Cox model, overall survival (OS) and progression-free survival (PFS) showed a positive correlation with EIAC use (hazard ratio [HR] = 0.75, p = 0.0028 and HR = 0.80, p = 0.022), even after adjustment for the known prognostic factors of age, performance status, extent of resection, steroid use, and baseline neurocognitive function. Specifically, the median OS was longer in EIAC compared with non-EIAC patients (12.3 vs 10.7 months, p = 0.0002). Similarly, PFS was longer in EIAC patients (5.6 vs 4.8 months, p = 0.003). No differences in median OS or PFS were observed when comparing patients with or without a history of seizures at baseline.
conclusionsParadoxically, enzyme-inducing anticonvulsant (EIAC) use correlated with superior outcome of patients with glioblastoma. These results suggest that in comparative clinical trials testing agents metabolized by P450 microsomal enzymes, treatment arms may need stratification for the proportion of patients receiving EIAC.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.