Valproic acid better than enzyme-inducing drugs for patients with glioblastoma needing antiepileptic
THURSDAY, Sept. 1 (HealthDay News) -- Patients with glioblastoma requiring antiepileptic drugs (AEDs) during temozolomide (TMZ)-based chemoradiotherapy have an improved overall survival with valproic acid (VPA) than with an enzyme-inducing antiepileptic drug (EIAED), according to a study published online Aug. 31 in Neurology.
Michael Weller, M.D., from the University Hospital Tübingen in Germany, and colleagues investigated whether the effectiveness of TMZ chemoradiotherapy in patients with newly diagnosed glioblastoma is modulated by AEDs. Data were collected from the European Organization for Research and Treatment of Cancer 2698122981/National Cancer Institute of Canada CE.3 clinical trial database of radiotherapy (RT). Data were adjusted for known prognostic factors, and were evaluated to identify the impact of the interaction between use of AED and chemoradiotherapy on survival with or without TMZ for newly diagnosed glioblastoma.
The investigators identified 175 patients not receiving any AEDs, 277 taking any EIAED, and 135 receiving any non-EIAED when treatment began. Compared to patients without an AED or patients taking an EIAED only, patients receiving VPA had more grade 3/4 thrombocytopenia and leukopenia. Overall survival was similar for patients receiving an AED at baseline and those not receiving any AED. More survival benefits from TMZ/radiotherapy appeared to be achieved in patients receiving VPA alone (hazard ratio [HR] 0.39) than in patients receiving an EIAED only and not receiving any AED (HR, 0.69 and 0.67, respectively).
"VPA may be preferred over an EIAED in patients with glioblastoma who require an AED during TMZ-based chemoradiotherapy," the authors write.
Several authors disclosed financial ties with the pharmaceutical and biomedical industries. The original clinical trial was funded and supplied with drugs by Schering-Plough.
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