Impact of levetiracetam use in glioblastoma: an individual patient-level meta-analysis assessing overall survival.

IF 2.5 3区医学 Q2 CLINICAL NEUROLOGY

Neurosurgical Review Pub Date : 2024-12-09 DOI:10.1007/s10143-024-03137-x

Martin Vychopen, Agi Güresir, Alim Emre Basaran, Erdem Güresir, Johannes Wach

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引用次数: 0

Abstract

Background: Levetiracetam (Lev), an antiepileptic drug (AED), enhances alkylating chemotherapy sensitivity in glioblastoma (GB) by inhibiting MGMT expression. This meta-analysis evaluates Lev's impact on GB treatment by analyzing overall survival of individual patient data (IPD) from published studies.

Methods: IPD was reconstructed using the R package IPDfromKM. Pooled IPD Kaplan-Meier charts of survival stratified by Lev therapy were created using the R package Survminer. One- and two-stage meta-analyses of Lev treatment regarding survival was performed.

Results: Three articles covering 825 patients were included out of 3567 screened records. Lev usage prevalence was 0.36. IPD from 590 IDH wild-type glioblastomas, with a median follow-up of 16.1 months, were utilized. Pooled data revealed median survival times of 19.2 months (95%CI: 16.4-22.0) for Lev users versus 16.5 months (95%CI: 15.2-17.8) for partial/no use (p = 0.006). One-stage meta-analysis indicated a significant association between Lev use and survival in IDH wild-type GB (HR: 1.33, 95%CI: 1.08-1.64, p = 0.007). Two-stage meta-analysis confirmed these results.

Conclusions: This meta-analysis highlights that Lev use may prolong survival in IDH wild-type GB patients. Further randomized trials are needed to confirm these findings and identify subgroups benefiting most from Lev treatment.

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来源期刊

Neurosurgical Review 医学-临床神经学

CiteScore

5.60

自引率

7.10%

发文量

191

审稿时长

6-12 weeks

期刊介绍： The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.