Samuel Kim - Department of Neurosurgery
Glioblastoma (GBM) is a currently incurable primary tumor with poor 2-year survival rates. The standard of care remains to be chemoradiotherapy after gross total resection of the tumor. Despite this, patients experience poor mortality and morbidity.
Tumor-Treating Fields (TTF) are a novel and heavily investigated tool that uses electrical currents to create locoregional disruptions in cell mitosis. Additionally, TTF can upregulate circulating neoantigens to promote the efficacy of immunotherapeutics with low overall toxicity to patients.
In the study by Mrugala and colleagues, the post-market surveillance results for TTF devices were described from North America, Europe, Israel, and Japan. The study complements previous reports of non-serious adverse events (AEs) such as skin reactions although at a common rate of 43%. 22% of patients presented with serious AEs such as seizures and brain edema. Exciting news is comparable AEs in the pediatric population which currently does not have labeled use of TTF therapy.
The study provides an overall strong message of TTF therapy safety for GBM. Excitingly, the narrative adds potential labeled usage for pediatric GBM (pGBM). Despite this, the audience should recognize that the study was retrospective and did not control for or describe all variables with complete accuracy. Moreover, the true nature of the efficacy and safety of TTF therapy has yet to be established.
Even so, this is a remarkable start to a hopefully safe and regulated use of TTF to reduce GBM mortality and the morbidity seen with traditional chemoradiation. Future investigations should review the efficacy of TTF for pGBM.
References:
Mrugala MM, Shi W, Iwomoto F, et al. Global post‑marketing safety surveillance of Tumor Treating Fields (TTFields) therapy in over 25,000 patients with CNS malignancies treated between 2011-2022. J Neurooncol. 2024;169(1):25-38. doi:10.1007/s11060-024-04682-7
Edited by AJ Jenkins - Surgical Section Editor
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