Abstract Details

Title Effect of Valproic Acid on Seizure Control and on Survival in Patients with Glioblastoma Multiforme

Topic Neuro-oncology

Presentation(s) P01 - (-)

Poster/Presentation
Number 096

Objective

Background GBM is the most frequent brain tumor in adults and radiochemotherapy with temozolomide produces a median survival of 14 months. The use of VPA may improve survival based on facilitating apoptosis of cancer cells.

Design/Methods A retrospective analysis was performed on 291 patients with GBM. The efficacy of VPA and LEV and as polytherapy was analyzed in 181 (62%) patients with seizures with a minimum follow-up of 6 months. Cox-regression survival analysis was performed on 165 patients treated by chemoradiation with both temozolomide and VPA for at least 3 months.

Results Monotherapy with either VPA or LEV was instituted in 137/143 (95,8 %) and in 59/86 (68.6 %) on VPA/LEV polytherapy as the next regimen. Initial seizure-freedom was achieved in 41/100 (41%) on VPA, in 16/37 (43.3%) on LEV and in 89/116 (76,7 %) on subsequent VPA/LEV polytherapy. At the end of follow-up, seizure-freedom was achieved in 77,8 % (28/36) on VPA alone, 25/36 (69,5 %) on LEV alone, and in 38/63 (60.3 %) on VPA/LEV polytherapy with ongoing seizures on monotherapy. Patients using VPA in combination with temozolomide showed a longer median survival of 69 weeks [95% CI:61.7;67.3] as compared to 61 weeks [95% CI 52.5;69.5] in the group without VPA (HR 0.63 [95% 0.43-0.92] p: 0.016), and adjusting for age, extent of resection and MGMT promoter methylation status.

Conclusions Polytherapy with VPA and LEV strongly contributes to seizure control to either of these as monotherapy. Use of VPA together with chemoradiation by temozolomide results in a 2 months longer survival of patients with GBM.

Authors/Disclosures
Melissa Kerkhof, MD (Medical Center Haaglanden, Neurology) PRESENTER	No disclosure on file
	No disclosure on file
Benn E. Smith, MD, FAAN	Dr. Smith has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for CSP Behring.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Martin J. Taphoorn, MD	No disclosure on file
Charles J. Vecht, MD, PhD, FAAN	No disclosure on file
	No disclosure on file

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