Glioblastoma is the most devastating primary
malignancy of the central nervous system in adults.
Most patients die within 1 to 2 years of diagnosis.
Tumor-treating fields (TTFields) are a
locoregionally delivered antimitotic treatment that
interferes with cell division and organelle
assembly.
The transducer array that sends electrical impulses
through the patient's brain and, at right, as worn
by patients. Novocure.
Clinical trial halted early after patients
experience 'meaningful' benefit from electrical
fields.
A wearable device that creates electrical fields to
suppress cancer cells’ proliferation in the brain
was so effective at extending patients’ survival
that the clinical trial in which it was being tested
was ended early.
Optune, the battery-powered, cap-like device, when
paired with standard-care temozolomide chemotherapy,
significantly prolonged progression-free and overall
survival of patients with newly diagnosed
glioblastoma, compared with patients who received
temozolomide alone.
Treatment with TTFields was delivered continuously
(>18 hours/day) via 4 transducer arrays placed on
the shaved scalp and connected to a portable medical
device. Temozolomide (150-200 mg/m2/d) was given for
5 days of each 28-day cycle.
Findings were published Dec. 15 in JAMA.
“With this new data, it appears the tumor-treating
fields should be used upfront and become a standard
of care. We should add this modality to what we’re
currently doing for our patients,” said Dr. Maciej
Mrugala, a brain-cancer specialist who led UW
Medicine’s participation in the clinical trial.
The addition of “tumor-treating fields” generated by
the noninvasive device resulted in median overall
survival of 20.5 months, versus 15.6 months with
chemotherapy alone.
The trial enrolled 695 patients from July 2009 and
November 2014 at 83 centers in North America, Europe
and South Korea. At the trial’s outset, researchers
specified an interim analysis of results from the
first 315 patients. It was after this analysis that
the trial was halted because patients’ outcomes were
so favorably affected.
“You get almost five months’ survival benefit. It
may not sound like a lot, but if you’re living with
this diagnosis, this is a meaningful improvement,”
said Mrugala. UW Medicine was one of the first 15
U.S. providers to employ the novel tumor-treating
therapy; now there are more than 200.
Glioblastoma multiforme is the most common primary
brain tumor and a highly aggressive cancer. The
Optune device, manufactured by Novocure, disrupts
cancer-cell reproduction by sending alternating
positive and negative charges between small ceramic
discs embedded in on four sides of the mesh cap.
The resulting low-intensity electric fields extend
through the brain and into the tumor cells’
membranes, physically causing cell fragmentation.
The frequency of the electric fields is “tuned” to
tumor cells’ replication rate, so it does not affect
normal cells, said Peter Melnyk, Novocure’s chief
commercial officer.
For more information
Maintenance Therapy With Tumor-Treating Fields Plus
Temozolomide vs Temozolomide Alone for Glioblastoma
- A Randomized Clinical Trial
Link...
University of Washington
Link...
Novocure
Link...
MDN |