April 14, 2024
Embolization

An Introduction to Tumor Treating Fields (TTFields) Therapy

Tumor Treating Fields, also known as TTFields, are a novel cancer treatment approach that uses alternating electric fields to disrupt cell division and stop tumor growth. This promising treatment modality is already approved for use against some cancers and is undergoing further clinical trials for other types of cancer indications. Let’s take a closer look at what TTFields therapy is and how it works.

How do TTFields Work?
TTFields disrupt this process by applying low-intensity, intermediate-frequency electric fields through insulated electrodes placed on the patient’s skin. These electric fields are tuned to specifically disrupt the electrostatic forces involved in protein-protein interactions and cargo transportation within cells undergoing mitosis. This essentially “gums up the works” of cell division and prevents newly formed cancer cells from properly replicating. The end result is apoptosis or programmed cancer cell death, while leaving healthy non-dividing cells largely unaffected.

Current Approved Uses

TTFields therapy is currently FDA-approved for the treatment of recurrent glioblastoma and malignant pleural mesothelioma. Glioblastoma is the most aggressive and common type of primary brain cancer, with median survival of just over one year even with the current standard of care. Clinical trials have shown Tumor Treating Fields  can significantly extend median and two year survival compared to chemotherapy alone when used as a maintenance therapy following initial treatment. For pleural mesothelioma, a rare cancer associated with asbestos exposure, TTFields have been shown to improve progression-free and overall survival compared to chemotherapy as a first-line monotherapy. Novocure, the maker of the Tumor Treating Fields delivery system, continues ongoing research to expand the use of TTFields to other solid tumor cancers.

Delivery of TTFields Therapy
To effectively generate the low-intensity intermediate-frequency electric fields needed for TTFields requires specialized medical devices and electrodes placed in direct contact with the patient’s skin. For glioblastoma, this involves placing transducer arrays inside flexible insulated arrays that are worn like a hat. For other cancers like pleural mesothelioma, electrodes are affixed around the chest wall. The transducer arrays or electrodes are connected to a portable generator that produces the alternating electric fields and regulates field strengths. Patients typically wear the device continuously for at least 18 hours per day throughout their treatment course to maintain the antimitotic effects of TTFields on dividing cancer cells. Proper device usage and medical oversight are important to ensure safety and effectiveness of the treatment.

Safety and Tolerability of TTFields
Overall, TTFields therapy has shown a favorable safety profile. Adverse events are typically mild to moderate skin irritation under the electrode arrays from continuous wear. More serious adverse events are rare. Large clinical trials and post-marketing data have not demonstrated increased risk of secondary cancers or significant elevation of normal tissue toxicity from TTFields treatment. Interference with pacemakers or implantable cardioverter-defibrillators is a potential concern, but modern devices can be reprogrammed to operate safely with TTFields therapy. The ease of continuous home administration and mild side effect profile make TTFields an attractive treatment option, either alone or in combination with other standard therapies.

Expanding Uses of TTFields
While already approved for glioblastoma and mesothelioma, ongoing clinical trials are exploring TTFields therapy for many other cancer types. These include phase 3 trials for lung cancer, brain metastases, ovarian cancer, pancreatic cancer, and gastric cancer. Early data across these diverse cancers have demonstrated acceptable tolerability as well as encouraging signs of anti-tumor activity. Other future directions include exploring potential synergies with immunotherapy or targeted drug therapies. By targeting the universal mechanisms of cell replication, TTFields hold promise as an effective treatment that can be broadly applied across many solid tumor types. Upcoming data readouts over the next few years will help determine if and how TTFields can become a new pillar of multimodality cancer care.

In summary, Tumor Treating Fields represent an innovative cancer therapeutic approach using alternating electric fields. By disrupting the mitotic process through low-intensity intermediate frequency fields, TTFields have shown survival benefits for glioblastoma and mesothelioma and may expand to treat other cancer types. With continuous home administration, mild side effects, and evidence of synergistic potential with other modalities, TTFields therapy offers an attractive treatment option that can enhance and extend patient outcomes. Oncology research continues striving to improve cancer care through novel scientific approaches like TTFields.

Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it