title: Case of glioblastoma patient treated with tumor treating fields therapy at recurrence degenerating to sarcoma.
abstract: Optune®treatment is a US FDA-approved treatment for glioblastoma (GBM) that employs alternating electric fields. Tumor treating field (TTF) therapy can exert its effects on GBM via cell cycle mitosis disruption and cytokinesis. We describe a patient with recurrent GBM who had disease progression following standard surgical treatment and concomitant chemoradiotherapy, and was found to have sarcomatous transformation after initiation of TTF therapy with bevacizumab. Upon tumor progression, repeat surgical resection revealed transformation into a GFAP-negative, reticulin-positive sarcoma with rhabdomyoid features. The possibility of a causal connection between TTF therapy and sarcomatous transformation needs to be further evaluated. No such case of apparent sarcoma formation in the CNS following chemoradiotherapy and/or TTF treatment for GBM has been reported.
authors.affiliation: University of California, Irvine School of Medicine, 1001 Health Sciences Rd, Irvine, CA 92617.
authors.forename: Pejman
authors.initials: P
authors.lastname: Majd
authors.affiliation: University of California, Irvine Medical Center, 200 S. Manchester Ave, Suite 206, Orange, CA 92868, USA.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: O'Connell
authors.affiliation: University of California, Irvine Medical Center, 200 S. Manchester Ave, Suite 206, Orange, CA 92868, USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kim
authors.affiliation: University of California, Irvine Medical Center, 200 S. Manchester Ave, Suite 206, Orange, CA 92868, USA.
authors.forename: Daniela A
authors.initials: DA
authors.lastname: Bota
authors.affiliation: University of California, Irvine Medical Center, 200 S. Manchester Ave, Suite 206, Orange, CA 92868, USA.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Carrillo
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy / Q000379:methods*; D004574:Electromagnetic Fields; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000628:therapy
keywords: Optune®; glioblastoma; glioma; recurrence; sarcoma; tumor treating fields