Alternating Electric Fields for the Treatment of Glioblastoma

Sampson, John H.

doi:10.1001/jama.2015.16701

Cited by 23 publications

(14 citation statements)

References 19 publications

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“…Patients treated with Optune™, in combination with temozolomide, demonstrated a statistically significant increase in progression-free survival compared with temozolomide alone (median progression-free survival of 7.2 months compared with 4.0 months, hazard ratio = 0.62, p = 0.001. There was also a statistically significant increase in overall survival compared with temozolomide alone (median overall survival of 20.5 months compared with 15.6 months, hazard ratio = 0.66, p = 0.004) [40][41][42]. It is noted that patients in the control arm received a median of four cycles of temozolamide, whereas patients in the Optune™ arm received six cycles of temozolamide, which is an additional confounding factor (patients lived longer therefore they got more temo).…”

Section: Tumor Treating Fieldsmentioning

confidence: 92%

“…The mechanism of action is the antimitotic action of the tumor treating fields interfering with cell division and organelle assembly within the rapidly replicating tumor cells. While microphotography has shown examples of prolonged mitoses and proliferation arrest, the specificity of the tumor treating fields for tumor cells only in the absence of an exact mechanism has raised skepticism within the Neuro-Oncology and Oncology clinician community [40].…”

Section: Tumor Treating Fieldsmentioning

confidence: 99%

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Current Trends in High-Grade Gliomas

Ahmad¹,

Sn²,

Turner³

et al. 2016

Neurooncology - Newer Developments

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Section: Tumor Treating Fieldsmentioning

confidence: 92%

Section: Tumor Treating Fieldsmentioning

confidence: 99%

Current Trends in High-Grade Gliomas

Ahmad¹,

Sn²,

Turner³

et al. 2016

Neurooncology - Newer Developments

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“…Others reference the regulatory burden of allowing patients in clinical trials to use a device that increases overall survival and potentially masks the effect of the investigational therapy in question. The lack of a sham device in the control arm to rule out a placebo effect has also been criticized , as has the fact that the designers of EF‐14 recommended continuation of the therapy despite disease progression, whereas previous investigators have traditionally discontinued therapy in this setting. Lastly, there is the inability to convince patients of the importance of device adherence or to accept therapy in the first place despite the therapy having considerably fewer side effects than surgery, systemic therapy, or radiation therapy.…”

Section: Controversies and Future Directionsmentioning

confidence: 99%

Integration of Tumor-Treating Fields into the Multidisciplinary Management of Patients with Solid Malignancies

2019

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Tumor-treating fields (TTFields) are a noninvasive antimitotic cancer treatment consisting of low-intensity alternating electric fields delivered to the tumor or tumor bed via externally applied transducer arrays. In multiple in vitro and in vivo cancer cell lines, TTFields therapy inhibits cell proliferation, disrupts cell division, interferes with cell migration and invasion, and reduces DNA repair. Human trials in patients with primary glioblastoma showed an improvement in overall survival, and trials in patients with unresectable malignant pleural mesothelioma showed favorable outcomes compared with historical control. This led to U.S. Food and Drug Administration approval in both clinical situations, paving the way for development of trials investigating TTFields in other malignancies. Although these trials are ongoing, the existing evidence suggests that TTFields have activity outside of neuro-oncology, and further study into the mechanism of action and clinical activity is required. In addition, because TTFields are a previously unrecognized antimitotic therapy with a unique mode of delivery, the oncological community must address obstacles to widespread patient and provider acceptance. TTFields will likely join surgery, systemic therapy, and radiation therapy as a component of multimodality management of patients with solid malignancies. The Oncologist 2019;24:e1426-e1436 Implications for Practice: Tumor-treating fields (TTFields) exhibit a broad range of antitumor activities. Clinically, they improve overall survival for patients with newly diagnosed glioblastoma. The emergence of TTFields has changed the treatment regimen for glioblastoma. Clinicians need to understand the practical issues surrounding its use in the multidisciplinary management of patients with glioblastoma. With ongoing clinical trials, TTFields likely will become another treatment modality for solid malignancies.

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“…This therapy is hypothesized to work via disruption of spindle formation during cellular division leading to mitotic arrest, and has been shown to work in vitro and in vivo . 88 An interim analysis from a multi-center randomized trial using a combinatorial approach with maintenance TMZ chemotherapy has recently been reported (NCT00916409). 89 The trial was terminated based on the positive results in the interim analysis, which showed an increased median PFS in the intent-to-treat population of 7.1 months in the TMZ and TTFs group compared to four months in the TMZ group.…”

Section: 0 Expert Opinionmentioning

confidence: 99%

The Safety of available immunotherapy for the treatment of glioblastoma

Farber

Elsamadicy

Atik

et al. 2017

Expert Opinion on Drug Safety

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Introduction Glioblastoma (GBM) is the most common malignant primary brain tumor in adults. Current standard of care involves maximal surgical resection combined with adjuvant chemoradiation. Growing support exists for a role of immunotherapy in treating these tumors with the goal of targeted cytotoxicity. Here we review data on the safety for current immunotherapies being tested in GBM. Areas covered Safety data from published clinical trials, including ongoing clinical trials were reviewed. Immunotherapeutic classes currently under investigation in GBM include various vaccination strategies, adoptive T cell immunotherapy, immune checkpoint blockade, monoclonal antibodies, and cytokine therapies. Trials include children, adolescents, and adults with either primary or recurrent GBM. Expert commentary Based on the reviewed clinical trials, the current immunotherapies targeting GBM are safe and well-tolerated with minimal toxicities which should be noted. However, the gains in patient survival have been modest. A safe and well-tolerated combinatory immunotherapeutic approach may be essential for optimal efficacy towards GBM.

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Alternating Electric Fields for the Treatment of Glioblastoma

Cited by 23 publications

References 19 publications

Current Trends in High-Grade Gliomas

Current Trends in High-Grade Gliomas

Integration of Tumor-Treating Fields into the Multidisciplinary Management of Patients with Solid Malignancies

The Safety of available immunotherapy for the treatment of glioblastoma

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