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Bianconi A, Koumantakis E, Gatto A, Zeppa P, Saaid A, Nico E, Bruno F, Pellerino A, Rizzo F, Junemann CV, Melcarne A, Garbossa D, Dalmasso P, Cofano F. Effects of Levetiracetam and Lacosamide on survival and seizure control in IDH-wild type glioblastoma during temozolomide plus radiation adjuvant therapy. Brain Spine 2023; 4:102732. [PMID: 38510602 PMCID: PMC10951696 DOI: 10.1016/j.bas.2023.102732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/23/2023] [Accepted: 12/08/2023] [Indexed: 03/22/2024]
Abstract
Introduction There are no clear indications for the best choice of anti-seizure medications to control brain tumor related epilepsy. In vitro studies have shown an antitumoral effect of Levetiracetam and Lacosamide on glioblastoma IDH-wild type. Research question This study investigates whether the use of levetiracetam and/or lacosamide impacts survival rates. The secondary aim was to evaluate the efficacy of both ASMs in controlling seizures. Materials and methods In this observational retrospective single-cohort study, patients underwent chemoradiation protocol after GBM surgery. They were grouped as follows: (1) use of levetiracetam, (2) use of lacosamide, (3) simultaneous use of levetiracetam and lacosamide, (4) no ASM usage. Survival curves were plotted using the Kaplan-Meier method coupled with a log-rank test for difference assesments. To evaluate the pharmacological efficacy of post-operative seizure control, a negative binomial regression was conducted. Results The study included 272 patients, 174 of which underwent adjuvant chemoradiation treatment. Patients without ASM therapy had a non-significant longer median OS (compared to the other groups (log-rank = 0.37). The IRR of seizure relapse was 2.57 (p = 0.007) times higher in lacosamide users, and MGMT promoter methylation demonstrated a protective effect against postoperative seizure onset (p = 0.05), regardless of the aforementioned confounding factors. Discussion and conclusions In patients diagnosed with GBM IDH-WT undergoing chemoradiation therapy, the use of levetiracetam or lacosamide for controlling BTRE does not seem to modify survival. Lacosamide users exhibited a higher IRR of postoperative seizures compared to levetiracetam users, and MGMT promoter methylation appears to be a protective factor.
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Affiliation(s)
- Andrea Bianconi
- Neurosurgery, Department of Neuroscience, University of Turin, Turin, Italy
| | - Emanuele Koumantakis
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Post Graduate School of Medical Statistics, University of Turin, Turin, Italy
| | - Andrea Gatto
- Neurosurgery, Department of Neuroscience, University of Turin, Turin, Italy
| | - Pietro Zeppa
- Neurosurgery, Department of Neuroscience, University of Turin, Turin, Italy
| | - Ayoub Saaid
- Neurosurgery, Department of Neuroscience, University of Turin, Turin, Italy
| | - Elsa Nico
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Francesco Bruno
- Neurooncology, Department of Neuroscience, University of Turin, Turin, Italy
| | - Alessia Pellerino
- Neurooncology, Department of Neuroscience, University of Turin, Turin, Italy
| | - Francesca Rizzo
- Neurosurgery, Department of Neuroscience, University of Turin, Turin, Italy
| | | | - Antonio Melcarne
- Neurosurgery, Department of Neuroscience, University of Turin, Turin, Italy
| | - Diego Garbossa
- Neurosurgery, Department of Neuroscience, University of Turin, Turin, Italy
| | - Paola Dalmasso
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Fabio Cofano
- Neurosurgery, Department of Neuroscience, University of Turin, Turin, Italy
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Saaid A, Monticelli M, Ricci AA, Orlando G, Botta C, Zeppa P, Bianconi A, Osella-Abate S, Bruno F, Pellerino A, Rudà R, Cassoni P, Garbossa D, Cofano F, Bertero L. Prognostic Analysis of the IDH1 G105G (rs11554137) SNP in IDH-Wildtype Glioblastoma. Genes (Basel) 2022; 13:genes13081439. [PMID: 36011350 PMCID: PMC9408597 DOI: 10.3390/genes13081439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
The G105G SNP (rs11554137) in the IDH1 gene is observed in about 10–15% of patients with a diffuse glioma. Data regarding its impact on gliomas are poor and partially conflicting, possibly due to the evolving classification of CNS tumors. The aim of this study was to investigate the G105G SNP prognostic significance in a homogenous cohort of IDH-wildtype glioblastomas, in agreement with the 2021 WHO classification. The study analyzed 211 patients by collecting several clinico-pathological and molecular characteristics, including the age, lesion localization, number of involved lobes, type of surgical treatment, disease outcome and MGMT promoter methylation status. PFS and DSS curves were plotted according to the Kaplan–Meier method and statistical analyses were performed using parametric and non-parametric tests. A total of 32 patients out of 211 (15.2%) were found to be G105G SNP carriers. No significant impact of the IDH1 G105G SNP on patients’ outcomes was observed in terms of PFS and DSS, while MGMT promoter methylation and gross total resection resulted as key prognostic factors in our cohort as expected. No prognostic impact of the IDH1 G105G SNP was detected in this strict cohort of IDH-wildtype glioblastomas. Analysis of larger cohorts is warranted to address the sample size limitations.
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Affiliation(s)
- Ayoub Saaid
- Neurosurgery Unit, Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy
| | - Matteo Monticelli
- Neurosurgery Unit, Department of Neuroscience and Rehabilitation, University of Ferrara, 44100 Ferrara, Italy
| | - Alessia Andrea Ricci
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Giulia Orlando
- Pathology Unit, Department of Oncology, University of Turin, 10126 Turin, Italy
| | - Cristina Botta
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Pietro Zeppa
- Neurosurgery Unit, Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy
| | - Andrea Bianconi
- Neurosurgery Unit, Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy
| | - Simona Osella-Abate
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Francesco Bruno
- Neuro-Oncology Unit, Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy
| | - Alessia Pellerino
- Neuro-Oncology Unit, Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy
| | - Roberta Rudà
- Neuro-Oncology Unit, Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy
- Department of Neurology, Castelfranco and Treviso Hospitals, 31100 Treviso, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Diego Garbossa
- Neurosurgery Unit, Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy
| | - Fabio Cofano
- Neurosurgery Unit, Department of Neuroscience “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
- Correspondence:
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Constant S, Saaid A, Jimenez-Chobillon M. Efficacy and safety evaluation of a hypertonic seawater solution enriched with manganese and copper salts. RHINOL 2021. [DOI: 10.4193/rhinol/21.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: Nasal irrigation is commonly recommended as an adjuvant treatment for blocked nose. In the present study, the safety and efficacy profile of Stérimar Blocked Nose (SBN), a hypertonic seawater solution enriched with manganese and copper salts, has been evaluated on nasal epithelium, in vitro. Methodology: 3D reconstituted human nasal epithelium tissue model, MucilAir™, has been used to investigate the safety of SBN on nasal epithelium by measuring trans-epithelial electrical resistance (TEER), cytotoxicity (lactate dehydrogenase (LDH) release) and phlogosis-related effects (interleukin-8 secretion). Efficacy assessment was measured by ciliary beat frequency (CBF), mucociliary clearance (MCC) and antimicrobial activities (against Staphylococcus aureus and Pseudomonas aeruginosa). Results: Four-day SBN treatment did not compromise the nasal epithelium integrity as TEER values were over the tissue integrity limit. SBN treatment did not exert cytotoxic (LDH release) or pro-inflammatory effects (IL-8 secretion). SBN treatment significantly increased the CBF and MCC rates compared to untreated cells. SBN treatment exerted a bactericidal effect on S. aureus and P. aeruginosa cultures, whereas seawater not enriched in copper and manganese had only a bacteriostatic effect. Conclusions: The results demonstrate that SBN is a safe formula for use on human nasal epithelium. The results also suggest a better potential therapeutic role for SBN in comparison to not-enriched seawater when used to control nasal congestion and inhibit bacterial growth which may cause nasal congestion.
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Huang S, Constant S, De Servi B, Meloni M, Culig J, Saaid A. Efficacy of a seawater solution enriched with copper, hyaluronic acid and eucalyptus against nasal pathogens. RHINOL 2019. [DOI: 10.4193/rhinol/19.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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