Seizure Treatment in Glioma

NCT ID: NCT03048084

Last Updated: 2025-02-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-02-01

Study Completion Date

2028-07-01

Brief Summary

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Currently, treatment with a specific anti-epileptic drug mainly depends on the physicians' preference, as there are no studies supporting the use of one specific anticonvulsant in glioma patients. The overall aim of this randomized controlled trial is to directly compare the effectiveness of treatment with levetiracetam or valproic acid in glioma patients with a first seizure.

Detailed Description

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Currently, treatment of glioma patients with a specific anti-epileptic drug (AED) mainly depends on the physicians' preference, as there is no robust evidence from randomized controlled trials supporting the use of one specific anticonvulsant above the other in glioma patients.

Levetiracetam and valproic acid are the most commonly used AEDs in glioma patients. Both drugs are used for the treatment of seizures, have similar toxicity profiles and are non-enzyme inducing AEDs, therefore not interfering with chemotherapeutic drugs. However, it is not known whether one drug is more effective than the other in reducing seizures.

Conditions

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Glioma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Levetiracetam

Patients in this treatment arm will receive levetiracetam monotherapy. The dosage depends on the specific treatment step, as indicated in the protocol. In step 1, patients will receive 2x500 mg/d levetiracetam in the form of tablets. In step 2, dosage is increased to 1x250 plus 1x500 mg/d and in step 3 to 2x1000 mg/d levetiracetam. In step 4, levetiracetam is increased to 2x1500mg/d. In the fifth treatment step, patients will receive 2x1500 mg/d levetiracetam, and another AED will be added. The type and dosage of this add-on AED is according to the physician's preference, but in line with current clinical practice in the Netherlands.

Group Type ACTIVE_COMPARATOR

Levetiracetam

Intervention Type DRUG

Antiepileptic drug levetiracetam

Valproic acid

Patients in this treatment arm will receive valproic acid monotherapy. The dosage depends on the specific treatment step, as indicated in the protocol. In step 1, patients will receive 2x500 mg/d valproic acid in the form of tablets. In step 2, dosage is increased to 1x250 plus 1x500 mg/d and in step 3 to 2x1000 mg/d valproic acid. In step 4, valproic acid dosage is increased to a maximum of 2x1250mg/d. In the fifth treatment step, patients will receive 2x1250mg valproic acid, and another AED will be added. The type and dosage of this add-on AED is according to the physician's preference, but in line with current clinical practice in the Netherlands.

Group Type ACTIVE_COMPARATOR

Valproic Acid

Intervention Type DRUG

Antiepileptic drug valproic acid

Interventions

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Levetiracetam

Antiepileptic drug levetiracetam

Intervention Type DRUG

Valproic Acid

Antiepileptic drug valproic acid

Intervention Type DRUG

Other Intervention Names

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Keppra Depakine

Eligibility Criteria

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Inclusion Criteria

* Histologically proven or suspected diffuse astrocytoma (Isocytrate Dehydrogenase-1 (IDH-1) wildtype or IDH-1 mutated), diffuse oligodendroglioma (IDH-1 mutated and 1p/19q co-deleted), anaplastic astrocytoma (IDH-1 wildtype or IDH-1 mutated), anaplastic oligodendroglioma (IDH-1 mutated and 1p/19q co-deleted), glioblastoma (IDH-1 wild-type or IDH-1 mutated), or diffuse astrocytoma not otherwise specified (NOS), anaplastic astrocytoma NOS, oligodendroglioma NOS, oligoastrocytoma NOS, anaplastic oligoastrocytoma NOS, anaplastic oligodendroglioma NOS or glioblastoma NOS.
* Adult patients: ≥18 years of age
* First epileptic seizure, no longer than 2 weeks ago
* Monotherapy with antiepileptic drugs is considered most appropriate at the time of randomization
* Willing to provide written informed consent

Exclusion Criteria

* Previously treated with antiepileptic drugs, except emergency treatment in the past 2 weeks
* History of non-brain tumor related epilepsy
* Pregnancy
* Presence of contra-indications for use of levetiracetam or valproic acid
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical Center Haaglanden

OTHER

Sponsor Role collaborator

Erasmus Medical Center

OTHER

Sponsor Role collaborator

Amsterdam UMC, location VUmc

OTHER

Sponsor Role collaborator

Leiden University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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j.a.f.koekkoek

MD PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Amsterdam UMC

Amsterdam, , Netherlands

Site Status SUSPENDED

Medisch Spectrum Twente

Enschede, , Netherlands

Site Status RECRUITING

Leiden University Medical Center

Leiden, , Netherlands

Site Status RECRUITING

Erasmus Medical Center

Rotterdam, , Netherlands

Site Status RECRUITING

Haaglanden Medical Center

The Hague, , Netherlands

Site Status RECRUITING

Countries

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Netherlands

Central Contacts

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Johan AF Koekkoek, MD, PhD

Role: CONTACT

0031715269111

Monique Baas

Role: CONTACT

0031715297012

Facility Contacts

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Angelique Sijben, MD

Role: primary

Johan AF Koekkoek, MD, PhD

Role: primary

0031715269111

Joost Jongen, MD, PhD

Role: primary

0031107040704

Lara Fritz

Role: primary

0031703302000

References

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van der Meer PB, Taphoorn MJB, Koekkoek JAF. Management of epilepsy in brain tumor patients. Curr Opin Oncol. 2022 Nov 1;34(6):685-690. doi: 10.1097/CCO.0000000000000876. Epub 2022 Jul 16.

Reference Type DERIVED
PMID: 35838207 (View on PubMed)

Lang F, Liu Y, Chou FJ, Yang C. Genotoxic therapy and resistance mechanism in gliomas. Pharmacol Ther. 2021 Dec;228:107922. doi: 10.1016/j.pharmthera.2021.107922. Epub 2021 Jun 23.

Reference Type DERIVED
PMID: 34171339 (View on PubMed)

Other Identifiers

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77353

Identifier Type: -

Identifier Source: org_study_id

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