Association of Clinical, Tumor, and Treatment Characteristics With Seizure Control in Patients With IDH1/2-Mutant Lower-Grade Glioma

Francesco Bruno ¹, Alessia Pellerino ¹, Marco Conti Nibali ¹

⁰From the Division of Neuro-Oncology (F.B., A.P., R.S., R.R.), Department of Neuroscience "Rita Levi Montalcini", University and City of Health and Science Hospital, Turin; Neurosurgical Oncology Unit (M.C.N., M.R., L. Bello), "Galeazzi - Sant'Ambrogio" IRCCS, Milan; Departments of Oncology and Hemato-Oncology (L. Bello) and Medical Biotechnology and Translational Medicine (M.R.), University of Milan; Division of Neuro-Oncology (E.P.), Department of Neuroscience "Rita Levi di Montalcini", University and City of Health and Science Hospital, Turin; Neurology Unit (E.P.), Department of Translational Medicine, University of Eastern Piedmont, Novara; Division of Neurosurgery (F.C., D.G.), Department of Neuroscience "Rita Levi Montalcini", University and City of Health and Science Hospital; Division of Radiotherapy (M.L.), Department of Oncology; and Pathology Unit (L. Bertero, P.C.), Department of Medical Sciences, University of Turin, Italy.

Neurology +

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April 29, 2024

View abstract on PubMed

Summary

Seizures are common in IDH-mutant lower-grade gliomas. Higher grade tumors and seizure freedom after treatment correlate with better seizure control and longer progression-free survival (PFS).

Area Of Science

Neuro-oncology
Neurosurgery
Epileptology

Background

IDH1/2-mutant lower-grade gliomas frequently cause seizures.
Understanding seizure control factors is crucial for patient management.

Purpose Of The Study

Investigate seizure correlations with tumor/patient characteristics.
Evaluate the impact of surgery and adjuvant treatments (AT) on seizure control.
Assess seizure outcomes along the disease trajectory.

Main Methods

Retrospective study of 150 patients with IDH1/2-mutant lower-grade glioma.
Inclusion based on 2021 WHO Classification and seizure presentation.
Exclusion of specific genetic alterations and MRI findings.
Seizure freedom assessed at multiple time points post-surgery and post-treatment.

Main Results

Grade 3 histology correlated with better seizure freedom at all assessed time points.
Adjuvant radiotherapy showed a trend towards reduced seizures at recurrence.
Seizure freedom post-surgery and AT was linked to longer progression-free survival (PFS).

Conclusions

Higher grade (3) IDH-mutant gliomas exhibit better seizure control.
Seizure freedom is a significant predictor of longer PFS.
Findings may inform clinical trial design for antitumor agents targeting seizures.