Tumor treating fields: a novel treatment modality and its use in brain tumors.
Tumor treating fields (TTFields) are low-intensity electric fields alternating at an intermediate frequency (200kHz), which have been demonstrated to block cell division and interfere with organelle assembly. This novel treatment modality has shown promise in a variety of tumor types. It has been evaluated in randomized phase 3 trials in glioblastoma (GBM) and demonstrated to prolong progression-free survival (PFS) and overall survival (OS) when administered together with standard maintenance temozolomide (TMZ) chemotherapy in patients with newly diagnosed GBM. TTFields are continuously delivered by 4 transducer arrays consisting each of 9 insulated electrodes that are placed on the patient's shaved scalp and connected to a portable device. Here we summarize the preclinical data and mechanism of action, the available clinical data, and further outlook of this treatment modality in brain tumors and other cancer indications.
CHUV University Hospital and Lausanne University, Departments of Clinical Neurosciences and Oncology, Lausanne, Switzerland (A.F.H., P.P.); University Hospital Zurich and University of Zurich, Department of Oncology, Zurich, Switzerland (R.S.) andreas.hottinger@chuv.ch roger.stupp@usz.ch.
Andreas F
AF
Hottinger
CHUV University Hospital and Lausanne University, Departments of Clinical Neurosciences and Oncology, Lausanne, Switzerland (A.F.H., P.P.); University Hospital Zurich and University of Zurich, Department of Oncology, Zurich, Switzerland (R.S.).
Patricia
P
Pacheco
CHUV University Hospital and Lausanne University, Departments of Clinical Neurosciences and Oncology, Lausanne, Switzerland (A.F.H., P.P.); University Hospital Zurich and University of Zurich, Department of Oncology, Zurich, Switzerland (R.S.) andreas.hottinger@chuv.ch roger.stupp@usz.ch.
Roger
R
Stupp
D000818:Animals; D001932:Brain Neoplasms / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000379:methods* / Q000639:trends; D005909:Glioblastoma / Q000628:therapy*; D006801:Humans
Eur J Cancer. 2012 Sep;48(14):2192-202
22608262
J Clin Oncol. 2010 Mar 1;28(7):1168-74
20124186
J Clin Oncol. 2013 Sep 10;31(26):3212-8
23940216
J Natl Cancer Inst. 2003 Jan 1;95(1):19-29
12509397
Lancet Oncol. 2014 Sep;15(10 ):1100-8
25163906
Biophys J. 1993 Jul;65(1):541-9
8369458
BMC Med Phys. 2009 Jan 08;9:1
19133110
J Appl Physiol. 1966 Sep;21(5):1619-23
5923236
Science. 2012 Sep 28;337(6102):1678-84
23019653
Cancer Res. 2004 May 1;64(9):3288-95
15126372
Lung Cancer. 2013 Sep;81(3):445-50
23891283
PLoS One. 2015 May 26;10(5):e0125269
26010837
J Clin Oncol. 2013 Nov 10;31(32):4085-91
24101040
J Membr Biol. 1982;67(1):13-26
7097755
Natl Cancer Inst Monogr. 1982 Jun;61:343-50
7177184
J Natl Cancer Inst. 1993 Mar 3;85(5):365-76
8433390
Biophys J. 1985 Apr;47(4):513-8
3986280
Sci Rep. 2015 Dec 11;5:18046
26658786
Semin Oncol. 2014 Jun;41 Suppl 4:S1-14
24794308
Semin Oncol. 2014 Oct;41 Suppl 6:S4-S13
25213869
Clin Exp Metastasis. 2009;26(7):633-40
19387848
JAMA. 2015 Dec 15;314(23 ):2535-43
26670971
Eur J Cancer. 2010 Apr;46(6):1033-40
20181476
Br J Cancer. 2000 Sep;83(5):588-93
10944597
Semin Oncol. 2014 Oct;41 Suppl 6:S35-41
25213867
Pancreatology. 2014 Jan-Feb;14(1):54-63
24555979
Proc Natl Acad Sci U S A. 2007 Jun 12;104(24):10152-7
17551011
Phys Med Biol. 2015 Sep 21;60(18):7339-57
26350296
N Engl J Med. 2005 Mar 10;352(10 ):987-96
15758009