Did adding tumor treating fields to chemotherapy help newly diagnosed glioblastoma patients live longer?
For people with newly diagnosed glioblastoma, the standard treatment includes surgery, radiation, and chemotherapy with temozolomide. Tumor treating fields (TTFields) are a newer therapy that uses low-intensity electrical fields to disrupt cancer cell division. The question is whether adding TTFields to chemotherapy helps patients live longer. Research shows that the combination does improve survival, though the benefit may be modest and comes with a higher risk of skin irritation.
What the research says
A large meta-analysis of 14 studies involving 2,376 patients (both newly diagnosed and recurrent glioblastoma) found that adding TTFields to chemotherapy significantly prolonged overall survival (OS) by 37% (hazard ratio [HR] = 0.63) and progression-free survival (PFS) by 38% (HR = 0.62) compared to chemotherapy alone 1. These results were statistically significant, meaning they are unlikely to be due to chance. The analysis included randomized controlled trials, controlled clinical trials, and observational studies, providing strong evidence for the benefit 1.
A retrospective study of 104 patients with newly diagnosed glioblastoma treated in routine clinical care also found that those who received TTFields plus the Stupp protocol (temozolomide and radiation) had higher 6-month survival rates compared to those who received the Stupp protocol alone 10. However, this study did not find a significant improvement in overall survival after accounting for other factors, suggesting that some of the benefit may be due to selection bias (patients who chose TTFields may have been healthier) 10.
A narrative review of TTFields therapy noted that clinical studies have demonstrated a survival advantage for TTFields in newly diagnosed glioblastoma, as well as in other cancers 11. The therapy is generally well-tolerated, but the meta-analysis found that skin irritation was significantly more common with TTFields (about 13 times higher risk) 1. Other side effects were similar between groups 1.
It is important to note that not all studies show a clear benefit. One randomized trial of a different drug (veliparib) added to temozolomide did not improve survival in patients with a specific genetic marker (MGMT-methylated glioblastoma), highlighting that not all combination therapies work 9. However, the evidence specifically for TTFields is positive overall.
What to ask your doctor
- Based on my specific tumor type and health status, is TTFields therapy recommended for me?
- What are the expected benefits in terms of survival and progression-free survival?
- What are the risks, especially skin irritation, and how can it be managed?
- How does TTFields therapy fit into my overall treatment plan, including surgery, radiation, and chemotherapy?
- Are there any other clinical trials or newer treatments I should consider?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.