Authors :
Presenting Author: Adrian Safa, MD – Mayo Clinic Florida
Guido Chiriboga, MD – Mayo Clinic Florida
Seyed Mirsattari, MD, PhD – Mayo Clinic Florida
Anteneh Feyissa, MD – Mayo Clinic Florida
Katherine Noe, MD, PhD – Mayo Clinic
David Burkholder, MD – Mayo Clinic
Alfredo Quinones-Hinojosa, MD – mayo clinic florida
William Tatum, DO – Mayo Clinic in Florida
Brin Freund, MD – Mayo Clinic in Florida
Rationale:
Cenobamate is approved for treating focal epilepsy and has potential for treating tumor related epilepsy (TRE) based on potential anti-tumor effects though there is little data on efficacy and safety in this patient population. Methods:
This was a retrospective, multi-center study of patients with TRE who were prescribed cenobamate as adjunctive treatment between January 2020 to November 2024 at Mayo Clinic in Florida, Minnesota, and Arizona. Drug efficacy was assessed, and factors that were predictive of response to treatment were analyzed.
Results:
A total of 17 patients were included, with 12 being drug resistant. The median seizure frequency for the entire group before starting cenobamate treatment was 12 (IQR= 4-64) per month, and after treatment at last follow up was 3 (IQR= 1-15) per month, with an overall 56.3% reduction. Four patients (23.5%) were seizure free, and 7 (41.1%) patients were responders (at least 50% seizure reduction). No adverse events were reported for patients on concurrent chemotherapy. Responders had significantly fewer seizures per month compared to non-responders (5.72 ± 10.29 vs 27.33± 30.17; p=0.030). Cenobamate maximum dose was 163.6 mg/day in the responder group, while 191.7 mg/day in the non-responders group. On the other hand, the mean concurrent ASMs were 2.09 vs 1.33 in respectively the responders and non-responders’ groups. No clinical factors were predictive of responsiveness (or lack thereof) to cenobamate. Conclusions:
This study demonstrates that adjunctive therapy with cenobamate treatment for TRE is a feasible and potentially effective option. Clinical history, including drug resistance, did not predict drug efficacy. No adverse effects were reported in those treated with chemotherapy. Further studies are needed to validate treatment response and safety.
Funding: None