Toledo M, et al. – Researchers performed this study to describe the clinical experience with lacosamide in neuro–oncological patients. In cases of cancer–related seizures, lacosamide was to be considered as an antiepileptic drug (AED). Lacosamide pharmacodynamics and pharmacokinetics allowed the achievement of responder rates over 50% with no serious adverse effects, amelioration of side effects from other AEDs or radio–/chemotherapy, and no significant drug interactions. Moreover, the intravenous formulation demonstrated clear benefits in acute conditions like status epilepticus.

• The researchers performed this multicenter retrospective study in patients with cancer-related seizures, who received lacosamide as an add-on therapy.

• The researchers included 48 patients with benign and malignant tumors, including primary brain tumors, lymphomas, systemic cancer with central nervous system involvement, or paraneoplastic encephalitis.
• In patients with either benign or malignant tumors, lacosamide was effective in the control of chronic seizures.
• In malignant tumors, the success rate was greater.
• Drug-resistant epilepsies were more likely correlated with benign tumors.
• In nearly 70% of patients, adverse events occurred, especially in acute conditions and correlated with the concomitant use of radio-/chemotherapy.
• In this study, lacosamide-related adverse events were often found to be somnolence and dizziness, which usually resolved after dose adjustment.
• Approximately 50% of the patients discontinued 1 of the baseline AEDs and decreased or discontinued dexamethasone after starting lacosamide.
• They treated 15 status epilepticus patients with intravenous lacosamide.
• Out of them, 73% of them had their condition resolved without serious drug-related adverse events.