Memantine for Prevention of Cognitive Late Effects in Children and Adolescents Receiving Radiation Therapy for Brain Tumors: A Randomized, Controlled, Pilot Trial.
Heather M Conklin, Raja B Khan, Jason M Ashford et al.
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In 30 seconds
This randomized, double-blind, placebo-controlled pilot trial assessed the feasibility, acceptability, and preliminary efficacy of memantine for preventing cognitive late effects in children and adolescents receiving brain-tumor irradiation. Thirty participants took memantine or placebo for 12 weeks, with cognitive assessments through 1 year. Participation was 71%; 88% completed the medication period, and 97% of medication was taken. At 12 weeks, memantine showed favorable effect sizes for processing speed, reading and math fluency, and fatigue; some fluency benefits remained at 1 year. The authors conclude that larger trials are needed to validate these preliminary findings.
Key findings
- Study participation was 71%; 88% completed 12 weeks of medication, and 97% of medication was taken.
- Side effects were minimal, with no between-group difference in increase in severity during medication (P > .23).
- At 12 weeks, effect sizes favored memantine for processing speed (ES = .61), reading fluency (ES = .45), math fluency (ES = .81), and fatigue (ES = .72).
- At 1 year, reading fluency (ES = .65) and math fluency (ES = .71) showed some persisting benefits.
Why it matters
Cognitive effects of brain irradiation can affect quality of life in children and adolescents. This pilot suggests that a 12-week memantine regimen during irradiation can be delivered with high adherence and minimal side effects, while showing preliminary signals across cognitive and fatigue outcomes. These findings provide a basis for further evaluation, but do not establish preventive efficacy.
What to keep in mind
This was a pilot trial with 30 participants; the authors state that the preliminary cognitive findings require validation in a larger trial.