Seizure control as a new metric in assessing efficacy of tumor treatment in low-grade glioma trials

Edward K Avila; Marc Chamberlain; David Schiff; Jaap C Reijneveld; Terri S Armstrong; Roberta Ruda; Patrick Y Wen; Michael Weller; Johan A F Koekkoek; Sandeep Mittal; Yoshiki Arakawa; Ali Choucair; Jorge Gonzalez-Martinez; David R MacDonald; Ryo Nishikawa; Aashit Shah; Charles J Vecht; Paula Warren; Martin J van den Bent; Lisa M DeAngelis

doi:10.1093/neuonc/now190

Seizure control as a new metric in assessing efficacy of tumor treatment in low-grade glioma trials

Neuro Oncol. 2017 Jan;19(1):12-21. doi: 10.1093/neuonc/now190. Epub 2016 Sep 20.

Authors

Edward K Avila¹, Marc Chamberlain², David Schiff², Jaap C Reijneveld², Terri S Armstrong², Roberta Ruda², Patrick Y Wen², Michael Weller², Johan A F Koekkoek², Sandeep Mittal², Yoshiki Arakawa², Ali Choucair², Jorge Gonzalez-Martinez², David R MacDonald², Ryo Nishikawa², Aashit Shah², Charles J Vecht², Paula Warren², Martin J van den Bent², Lisa M DeAngelis²

Affiliations

¹ Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York (E.K.A., L.M.D.); Department of Neurology, University of Washington, Seattle, Washington (M.C.); Department of Neurology, University of Virginia, Charlottesville, Virginia (D.S.); Department of Neurology, VUmc Cancer Center, Amsterdam, Netherlands (J.C.R.); Department of Family Health, University of Texas Health Science Center, Houston, Texas (T.S.A.); Department of Neuro-Oncology, City of Health and Science Hospital, Torino, Italy (R.R.); Center for Neuro-Oncology, Dana-Farber Cancer Institute/ Brigham and Women's Center, Boston, Massachusetts (P.W.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Department of Neurology, Leiden University Medical Center, The Hague, Netherlands (J.A.F.K.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (S.M.); Department of Neurosurgery, Kyoto University School of Graduate Medicine, Kyoto, Japan (Y.A.); Department of Neurology, Southern Illinois University School of Medicine, Springfield, Illinois (A.C.); Department of Epilepsy and Surgery Center, Cleveland Clinic, Cleveland, Ohio (J.G.-M.); Department of Neurology, London Health Sciences Center, London, Ontario, Canada (D.R.M.); Department of Neurosurgery, Saitama Medical University, Saitama, Japan (R.N.); Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan (A.S.); Service Neurologie Mazarin, CHU Pitie-Salpetriere, Paris, France (C.J.V.); Department of Neurology, University of Alabama, Birmingham, Alabama (P.W.); Department of Neuro-Oncology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands (M.J.v.d.B.) avilae@mskcc.org.
² Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York (E.K.A., L.M.D.); Department of Neurology, University of Washington, Seattle, Washington (M.C.); Department of Neurology, University of Virginia, Charlottesville, Virginia (D.S.); Department of Neurology, VUmc Cancer Center, Amsterdam, Netherlands (J.C.R.); Department of Family Health, University of Texas Health Science Center, Houston, Texas (T.S.A.); Department of Neuro-Oncology, City of Health and Science Hospital, Torino, Italy (R.R.); Center for Neuro-Oncology, Dana-Farber Cancer Institute/ Brigham and Women's Center, Boston, Massachusetts (P.W.); Department of Neurology, University Hospital Zurich, Zurich, Switzerland (M.W.); Department of Neurology, Leiden University Medical Center, The Hague, Netherlands (J.A.F.K.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (S.M.); Department of Neurosurgery, Kyoto University School of Graduate Medicine, Kyoto, Japan (Y.A.); Department of Neurology, Southern Illinois University School of Medicine, Springfield, Illinois (A.C.); Department of Epilepsy and Surgery Center, Cleveland Clinic, Cleveland, Ohio (J.G.-M.); Department of Neurology, London Health Sciences Center, London, Ontario, Canada (D.R.M.); Department of Neurosurgery, Saitama Medical University, Saitama, Japan (R.N.); Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan (A.S.); Service Neurologie Mazarin, CHU Pitie-Salpetriere, Paris, France (C.J.V.); Department of Neurology, University of Alabama, Birmingham, Alabama (P.W.); Department of Neuro-Oncology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands (M.J.v.d.B.).

Abstract

Patients with low-grade glioma frequently have brain tumor-related epilepsy, which is more common than in patients with high-grade glioma. Treatment for tumor-associated epilepsy usually comprises a combination of surgery, anti-epileptic drugs (AEDs), chemotherapy, and radiotherapy. Response to tumor-directed treatment is measured primarily by overall survival and progression-free survival. However, seizure frequency has been observed to respond to tumor-directed treatment with chemotherapy or radiotherapy. A review of the current literature regarding seizure assessment for low-grade glioma patients reveals a heterogeneous manner in which seizure response has been reported. There is a need for a systematic approach to seizure assessment and its influence on health-related quality-of-life outcomes in patients enrolled in low-grade glioma therapeutic trials. In view of the need to have an adjunctive metric of tumor response in these patients, a method of seizure assessment as a metric in brain tumor treatment trials is proposed.

Keywords: glioma; low-grade; metric; scale; seizures.

Publication types

Review
Research Support, N.I.H., Extramural

MeSH terms

Brain Neoplasms / complications*
Brain Neoplasms / therapy
Epilepsy / etiology
Epilepsy / prevention & control*
Glioma / complications*
Glioma / therapy
Humans
Seizures / etiology
Seizures / prevention & control*
Treatment Outcome

Grants and funding

P30 CA008748/CA/NCI NIH HHS/United States