Treating glioblastomas with electrical currents to prolong survival
Of all brain tumors, glioblastoma has one of the worst prognoses. After surgery and chemotherapy, patients survive on average around 15 months; approximately 30 percent are still alive at two years. “Glioblastoma is still thought of as an incurable disease and, for that reason, additions to the standard of care regimen are necessary and beneficial,”says Scott M. Lindhorst, M.D., a neuro-oncologist at MUSC Hollings Cancer Center.
News that a novel noninvasive therapy—tumor-treating fields (TTFields)—extended survival by five months in recurrent glioblastoma generated considerable interest in 2011, and it soon became part of the standard of care for that disease. Last year, TTFields were approved by the FDA for use in patients with newly diagnosed glioblastoma as well.
TTFields are low-intensity, alternating electric fields that prevent proliferation of cancer cells by disrupting mitosis. Patients wear a battery-operated cap containing an array of ceramic discs, which deliver the fields to targeted regions of the brain. The cap and its placement are customized to the patient’s tumor, based on their MRI brain imaging. The longer the patient is able to wear the cap throughout the day, the better the outcomes seen. Although the therapy requires a lifestyle adjustment, it is well tolerated by most motivated patients.
“The next step is now to determine whether we can expand the use of this device to other tumor types, and that’s where the research we’re doing is heading,” says neuro-oncologist David M. Cachia, M.D. Cachia and Lindhorst are beginning clinical trials in patients who have lung cancer that has metastasized to the brain and are collaborating with investigators at other institutions to monitor outcomes with TTFields in patients with lower-grade gliomas. While TTFields do not currently cure brain tumors, they do significantly prolong survival of patients with these notoriously difficult-to-treat tumors.
Progressnotes Summer 2018