title: Critical review of the addition of tumor treating fields (TTFields) to the existing standard of care for newly diagnosed glioblastoma patients.
abstract: Since 2005, the standard of care for patients with newly diagnosed glioblastoma (GBM) has consisted of maximal resection followed by radiotherapy plus daily temozolomide (TMZ), followed by maintenance TMZ. In patients selected for clinical trials, median overall survival (OS) and progression-free survival (PFS) with this regimen is 15-17 months and 6-7 months, respectively. There have been various, largely unsuccessful attempts to improve on this standard of care. With the FDA approval of the tumor-treating fields (TTFields) device, Optune, for recurrent GBM (2011), and the more recent EF-14 interim trial results and approval for newly diagnosed GBM patients, several questions have arisen. A roundtable of experts was convened at the 2015 ASCO meeting to engage in an open conversation and debate of the EF-14 results presented at that meeting and their implications for neuro-oncology practice and clinical research. In October 2015, subsequent to the roundtable discussion, TTFields received FDA approval for newly diagnosed GBM.
authors.affiliation: Deputy Director, Miami Cancer Institute, and Chief of Radiation Oncology, Miami, Florida. Electronic address: mineshpmehta@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Mehta
authors.affiliation: Department of Neurology, Harvard University, Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA.
authors.forename: P
authors.initials: P
authors.lastname: Wen
authors.affiliation: Japanese Society of Neuro-Oncology, Department of Neurosurgery, Saitama International Medical Center and University, Saitama, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Nishikawa
authors.affiliation: Center for Neuro-Oncology, Harvard Medical School, Boston, MA, United States.
authors.forename: D
authors.initials: D
authors.lastname: Reardon
authors.affiliation: Medicine, Duke University Medical Center, Durham, NC, United States.
authors.forename: K
authors.initials: K
authors.lastname: Peters
mesh_terms: D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000592:standards*; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D059039:Standard of Care; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide