Treatment of Glioblastoma (GBM) with the Addition of Tumor-Treating Fields (TTF): A Review

Abstract

Glioblastoma (GBM) is the most common primary brain tumor. Despite aggressive treatment, GBM almost always recurs. The current standard-of-care for treatment of newly diagnosed GBM has remained relatively unchanged since 2005: maximal safe resection followed by concomitant chemoradiation (CRT) with temozolomide (TMZ), and subsequent adjuvant TMZ. In 2011, the first-generation tumor treating fields (TTF) device, known at the time as the NovoTTF-100A System (renamed Optune), was approved by the Food and Drug Administration (FDA) for treatment of recurrent GBM. The TTF device was subsequently approved as an adjuvant therapy for newly-diagnosed GBM in 2015. The following is a review of the TTF device, including evidence supporting its use and limitations.

Construction of lncRNA‐associated ceRNA networks to identify prognostic lncRNA biomarkers for glioblastoma

“…GBM accounts for a vast majority of malignant brain tumors in the central nervous system and has high mortality and disability rates 1 . Although aggressive treatments, such as maximal resection, adjuvant radiotherapy, and chemotherapy are used for patients with GBM, the survival rate is still difficult to improve, 15 due to the poor understanding of the pathogenesis of GBM and the lack of an effective therapeutic target. Previous studies have reported that differential genes play an important role in the pathology of tumors and may be potential therapeutic targets 16–18 .…”

Barium Titanate Nanoparticles Sensitise Treatment-Resistant Breast Cancer Cells to the Antitumor Action of Tumour-Treating Fields

“…Although there is an accumulating body of evidence demonstrating enhanced efficacy of the combined treatment of TTFields and chemotherapeutic agents or radiotherapy 1,2,9,[11][12][13][14][15][16][17][18]29 , not much is known about TTFields-responsive sensitisers. Here, we report novel TTFields-responsive sensitisers, BTNPs, characterised by high dielectric constants.…”

“…Many preclinical and clinical studies indicate that TTFields would be applicable for other tumour types including breast, lung, pancreatic, and ovarian cancers 4,6,7,9,10 . Early clinical trials have shown that only TTFields treatment for GBM patients was not significantly better than conventional chemotherapy 3,9,[11][12][13] . However, recent preclinical studies suggest that combination therapy of TTFields with conventional treatments including chemotherapy, immunotherapy, and radiotherapy are more effective than TTFields monotherapy in GBM 1,2,9,[11][12][13][14][15][16][17][18] .…”

Glioblastoma Cell Migration is Directed by Electrical Signals

“…This however this concept has yet to be fully investigated and may not be clinically feasible based on the requirements for medical screening tests [43]. However, the Food and Drug Administration approved in 2005 Novocure's Tumour Treatment Fields (renamed recently to Optune), which utilises alternating current across the cranium in recurrent post-surgical GBM in combination with chemotherapy [44]. As such, the use of a direct current EF to manipulate GBM cell migration has yet to be optimised for clinical use.…”