Recent advances in Tumor Treating Fields (TTFields) therapy for glioblastoma

被引:6
作者
Khagi, Simon [1 ]
Kotecha, Rupesh [2 ]
Gatson, Na Tosha N. [3 ,4 ,5 ]
Jeyapalan, Suriya [6 ]
Abdullah, Huda Ismail [7 ]
Avgeropoulos, Nicholas G. [7 ]
Batzianouli, Eleni T. [8 ]
Giladi, Moshe [9 ]
Lustgarten, Leonardo [7 ]
Goldlust, Samuel A. [10 ]
机构
[1] Hoag Family Canc Inst, Newport Beach, CA USA
[2] Baptist Hlth South Florida, Miami Canc Inst, Dept Radiat Oncol, Miami, FL USA
[3] Indiana Univ Sch Med, Neurooncol Ctr Excellence, Indianapolis, IN USA
[4] IU Hlth Neurosci & Simon Canc Inst, Indianapolis, IN USA
[5] Geisinger Commonwealth Sch Med, Scranton, PA USA
[6] Tufts Med Ctr, Boston, MA USA
[7] Novocure Inc, New York, NY USA
[8] Novocure GmBH, Root, Switzerland
[9] Novocure Ltd, Haifa, Israel
[10] St Lukes Canc Inst, Dept Neurooncol, Kansas City, MO USA
关键词
Tumor Treating Fields; glioblastoma; brain tumor; alternating electric field; antitumor immunity; medical device; NEWLY-DIAGNOSED GLIOBLASTOMA; PLUS MAINTENANCE TEMOZOLOMIDE; NOVOTTF-100A(TM) SYSTEM; RECURRENT GLIOBLASTOMA; CELL-PROLIFERATION; EFFICACY; PHASE-2; CHEMOTHERAPY; RADIOTHERAPY; CONCOMITANT;
D O I
10.1093/oncolo/oyae227
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Tumor Treating Fields (TTFields) therapy is a locoregional, anticancer treatment consisting of a noninvasive, portable device that delivers alternating electric fields to tumors through arrays placed on the skin. Based on efficacy and safety data from global pivotal (randomized phase III) clinical studies, TTFields therapy (Optune Gio) is US Food and Drug Administration-approved for newly diagnosed (nd) and recurrent glioblastoma (GBM) and Conformit & eacute; Europ & eacute;enne-marked for grade 4 glioma. Here we review data on the multimodal TTFields mechanism of action that includes disruption of cancer cell mitosis, inhibition of DNA replication and damage response, interference with cell motility, and enhancement of systemic antitumor immunity (adaptive immunity). We describe new data showing that TTFields therapy has efficacy in a broad range of patients, with a tolerable safety profile extending to high-risk subpopulations. New analyses of clinical study data also confirmed that overall and progression-free survival positively correlated with increased usage of the device and dose of TTFields at the tumor site. Additionally, pilot/early phase clinical studies evaluating TTFields therapy in ndGBM concomitant with immunotherapy as well as radiotherapy have shown promise, and new pivotal studies will explore TTFields therapy in these settings. Finally, we review recent and ongoing studies in patients in pediatric care, other central nervous system tumors and brain metastases, as well as other advanced-stage solid tumors (ie, lung, ovarian, pancreatic, gastric, and hepatic cancers), that highlight the broad potential of TTFields therapy as an adjuvant treatment in oncology. This article reviews the mechanism, efficacy, safety, and quality of life of Tumor Treating Fields (TTFields) therapy in glioblastoma. This unique noninvasive treatment uses a portable device to deliver electric fields to the tumor using arrays that are placed on the skin and kill cancer cells in several ways.
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页数:18
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