Long-term survival of patients suffering from glioblastoma multiforme treated with tumor-treating fields

Abstract

Glioblastoma multiforme (GBM) is the most common and malignant primary intracranial tumor, and has a median survival of only 10 to 14 months with only 3 to 5% of patients surviving more than three years. Recurrence (RGBM) is nearly universal, and further decreases the median survival to only five to seven months with optimal therapy. Tumor-treating fields (TTField) therapy is a novel treatment technique that has recently received CE and FDA approval for the treatment of RGBM, and is based on the principle that low intensity, intermediate frequency electric fields (100 to 300 kHz) may induce apoptosis in specific cell types. Our center was the first to apply TTField treatment to histologically proven GBM in a small pilot study of 20 individuals in 2004 and 2005, and four of those original 20 patients are still alive today. We report two cases of GBM and two cases of RGBM treated by TTField therapy, all in good health and no longer receiving any treatment more than seven years after initiating TTField therapy, with no clinical or radiological evidence of recurrence.

Post Hoc Analyses of Intention-to-Treat Population in Phase III Comparison of NovoTTF-100A™ System Versus Best Physician’s Choice Chemotherapy

“…Recent reports of recurrent GBM patients alive 6 years or more after beginning NovoTTF Therapy highlight the need to better identify the clinical characteristics of patients predictive of a robust response to NovoTTF therapy. 18,19 Furthermore, another recent post hoc analysis of the phase III data found higher proportions of secondary GBM (prior low-grade histology) and low dexamethasone usage in recurrent GBM patients who responded to NovoTTF Therapy than in those who did not. 20 The authors suggested that these as well as other genetic/epigenetic factors might determine response to Novo TTF Therapy.…”

“…Of particular interest was the subgroup consisting of patients who had previously failed bevacizumab therapy. More generally, there have been recent reports of very extended and ongoing survival of a subset of patients treated with NovoTTF Therapy, 18,19 and the post hoc analyses here represent an attempt to identify patient-or disease-related characteristics predictive of response to NovoTTF Therapy. A recent post hoc study by Wong and coworkers 20 of the pivotal phase III trial data identified prior lowgrade histology and lower cumulative dexamethasone dose as important factors distinguishing NovoTTF Therapy responders from nonresponders among recurrent GBM patients.…”

Classifying Glioblastoma Multiforme Follow-Up Progressive vs. Responsive Forms Using Multi-Parametric MRI Features

“…The patients have a median survival of only 10–14 months after diagnosis with only 3–5% of patients surviving more than three years. Recurrence is universal, and at the time of relapse, the median survival is only 5–7 months despite therapy (Rulseh et al, 2012). The current standard of care is surgical resection followed by radiotherapy and concomitant adjuvant temozolomide chemotherapy (Stupp et al, 2005).…”

Inhibition of KIF14 Suppresses Tumor Cell Growth and Promotes Apoptosis in Human Glioblastoma

“…When the tumor volume reached 50 mm 3 , the mice were randomly divided into four groups (n = 5 per group). Each group was treated with KIF14 siRNA or nonsense siRNA through local injection of the xenograft tumor at multiple sites.…”

“…The current treatment of gliomas includes surgical resection and radiotherapy in combination with adjuvant chemotherapy. However, the prognosis of patients with glioma is poor, and the median overall survival of patients with GBM is 12-15 months, with only 3-5% of patients surviving more than 3 years [3]. The recurrence rate of GBM is almost 100%, and patients with recurrent GBM have a median survival of 5-7 months [4].…”