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Abstract Details

Efficacy, Tolerability, and Safety of Cenobamate in Adult Patients With Supratentorial Brain Tumor Related Epilepsy: A Single Center Study
Neuro-oncology
S28 - Neuro-oncology: Clinical and Practice Updates (4:06 PM-4:18 PM)
004

To assess the effectiveness, tolerability, and safety of adjunctive cenobamate in tumor related epilepsy (TRE).

Cenobamate is a novel anti-seizure medication (ASM) which can significantly improve seizure control in patients with medically refractory focal epilepsy. However, there is limited data about its efficacy and safety in patients with brain tumors.

This was a retrospective, observational study of adult patients treated with cenobamate at MSKCC between 11/21/2019 and 6/30/2025. The maximum allowed daily dose was 400 mg/day. Drug efficacy was assessed using the RANO-TREAT score which is a seizure control assessment tool to monitor seizures in patients with gliomas, with higher score representing worse seizure control, and cumulative incidence rates of seizure improvement post-cenobamate initiation with 95% confidence intervals (CI). Change in number of ASMs were compared with the Wilcoxon signed rank test.
Eighteen (18) patients were included with median age of 43 (range=22-75). All the patients had a primary brain tumor. Thirteen patients (72.2%) had focal preserved consciousness seizures. The average number of concomitant ASMs at cenobamate initiation and last follow up were 2.44 and 1.83, respectively (P-Value=0.005). The median RANO-TREAT score prior to cenobamate treatment initiation was 29 (range=6-460), and at mid and last follow-up, was 13.5 (range=3-255) and 12 (range=3-96), respectively. There was a cumulative incidence rate of seizure reduction post-cenobamate initiation of 43.3% (95% CI:18.6%-65.9%), 55.9% (95% CI: 27.8%-76.8%), 62.2% (95% CI: 32.8%-81.7%), and 74.79% (95% CI: 43.2%-90.5%) at 3-, 4-, 5- and 6-months, respectively. There was 88% improvement in seizures from cenobamate initiation to last follow-up. Eleven patients (61.1%) tolerated cenobamate without adverse events and 7 patients (38.9%) reported at least one self-limited adverse event.

Treatment with adjunctive cenobamate in patients with TRE led to notable cumulative incidence rates of seizure improvement with self-limiting adverse events.  
Authors/Disclosures
Gira I. Graciano Mireles, MD
PRESENTER 		Dr. Graciano Mireles has nothing to disclose.
Anne S. Reiner Mrs. Reiner has nothing to disclose.
David Q. Mao, MD (Memorial Sloan Kettering) Dr. Mao has nothing to disclose.
Katherine S. Panageas, PhD Dr. Panageas has nothing to disclose.
Edward Avila, DO, FAAN (Memorial Sloan-Kettering Cancer Center) Dr. Avila has received publishing royalties from a publication relating to health care.