NovoTTF-100A: a new treatment modality for recurrent glioblastoma

Abstract

NovoTTF-100A (Novocure Inc., Haifa, Israel) is a first-of-a-kind device approved by the US FDA for the treatment of recurrent glioblastoma. It works by emitting a low-intensity, intermediate-frequency (200 kHz), alternating electric field administered via insulated transducer arrays applied onto the scalp. The electric field penetrates the brain and inhibits the growth and proliferation of glioblastoma by interfering with tumor cell mitosis at anaphase. Results from a Phase III clinical trial indicate that the efficacy of NovoTTF-100A is equivalent to standard-of-care chemotherapy. The side effect profile favors device-treated patients, obviating typical toxicities associated with chemotherapy or targeted drugs, and results in improvements in their quality of life. NovoTTF-100A is a new modality of cancer treatment that offers equivalent efficacy, but less toxicity, to recurrent glioblastoma patients when compared with existing treatments.

Tumor-treating fields plus chemotherapy versus chemotherapy alone for glioblastoma at first recurrence: a post hoc analysis of the EF-14 trial

“…TTFields delivers low-intensity, intermediate-frequency (200 kHz) alternating electric fields via transducer arrays applied to the shaved scalp [9][10][11][12][13][14][15][16]. In the randomized Phase III trial (EF-14; NCT00916409) of TTFields in newly CliniCal Trial evaluaTion future science group diagnosed patients with GBM after initial treatment with standard chemoradiation, the combination of TTFields plus maintenance temozolomide significantly improved progression-free survival (PFS) and overall survival (OS) compared with temozolomide alone in a prespecified interim analysis.…”

Advances in the Treatment of Primary Brain Tumors: The Realm of Immunotherapy

“…The most recent FDA-approved treatment for GBM is Novocure's Optune device, which uses a noninvasive tumor treating field generator that results in the slowing and ultimate reversal of tumor growth [109,110]. The concept of the device is that it creates low intensity, alternating electric fields within the tumor site that act on the electrically charged cellular components, thereby preventing normal cellular functions such as mitosis, which ultimately leads to tumor cell death [109].…”

“…The concept of the device is that it creates low intensity, alternating electric fields within the tumor site that act on the electrically charged cellular components, thereby preventing normal cellular functions such as mitosis, which ultimately leads to tumor cell death [109]. In a prospective, randomized, multi-institutional control trial designed to compare the effectiveness and safety of newly diagnosed GBM subjects treated with Optune in combination with temozolomide (TMZ) (n = 210) to those treated with TMZ alone (n = 105), progression-free survival in the treatment arm was 7.1 months compared to 4.0 months in the TMZ only group [111].…”

Tumor Treating Field Therapy in non-MGMT-Methylated Newly Diagnosed Glioblastoma: Is there a Role for Temozolomide?

“…Since the TMZ advance over a decade ago, a new technology has been developed and refined: A system of alternating, low intensity, intermediate frequency, tumor-treating electric fields (TTFields) to the patients' brain via noninvasive transducer arrays attached to the scalp has been developed and successfully introduced into GBM clinical practice (see Figure 1) [9] . The preclinical rationale for TTFields resides in its ability to inhibit cell growth and induce cell death in a wide range of tumor models [10,11] .…”