Real-world experience with TTFields in glioma patients with emphasis on therapy usage
Tumor Treating Fields (TTFields) has emerged as a significant adjunctive component in the treatment of high-grade gliomas following the EF-14 trial in 2017. The incorporation of TTFields, alongside cyclic temozolomide therapy, has demonstrated improved patient outcomes when the usage exceeds 18 h pe...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1430793/full |
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| author | Claudius Jelgersma Joan Alsolivany Gülsüm Akkas David Wasilewski David Wasilewski Bastian Gastl Martin Misch David Capper David Capper David Kaul David Kaul Lars Bullinger Lars Bullinger Peter Vajkoczy Julia Onken Julia Onken Julia Onken |
| author_facet | Claudius Jelgersma Joan Alsolivany Gülsüm Akkas David Wasilewski David Wasilewski Bastian Gastl Martin Misch David Capper David Capper David Kaul David Kaul Lars Bullinger Lars Bullinger Peter Vajkoczy Julia Onken Julia Onken Julia Onken |
| author_sort | Claudius Jelgersma |
| collection | DOAJ |
| description | Tumor Treating Fields (TTFields) has emerged as a significant adjunctive component in the treatment of high-grade gliomas following the EF-14 trial in 2017. The incorporation of TTFields, alongside cyclic temozolomide therapy, has demonstrated improved patient outcomes when the usage exceeds 18 h per day (75% usage). Post-hoc analysis of the EF-14 trial has demonstrated that therapy usage exceeding 90% is associated with an additional benefit, while rates above 50% have also proven effective in literature. Given the cost-intensive nature and mild- to- moderate constraints associated with the therapy, our objective is to generate real-world data on therapy usage through a retrospective analysis at a high-throughput academic center. Between June 2015 and February 2022, a total of 113 high-grade glioma patients received TTFields therapy. Eight patients discontinued TTFields therapy within 2 months with less than 50% usage and were excluded from further analysis. For the remaining patients, the median age was 51 years (range: 20–76 years) and the mean preoperative Karnofsky index was 80%–90%. Most of the patients (75.2%) initiated therapy concurrently with first-line treatment, of whom 27.6% started TTFields therapy concomitant to the first cycle of temozolomide. 15.2% started TTFields therapy in the second-line and 9.5% in the third-line setting. The study cohort had an average therapy duration of 9.3 months with 3.2 break days per month. The mean therapy usage was 65.5% (SD 17.6%). Usage was highest during the first 3 months, with rates of 77.7%, 72.3%, and 71.6%, and then dropped to around 60% in the following 6 months. Linear regression found no predictors of usage, such as age, timing of therapy initiation, and duration or gender. 55% of patients continued TTFields beyond the first recurrence. Interestingly, no drop in usage rates was observed before tumor recurrence was communicated. However, after diagnosis, patients exhibited a significant drop in usage to an average of 52.3%. This high-volume, real-world TTFields usage data reveal that the extent of usage falls short of the intended 75%. It highlights the importance of monitoring and promoting adherence to maximize its potential benefits in managing high-grade glioma patients. Furthermore, strategies to expedite therapy initiation and improve long-term adherence are warranted. |
| format | Article |
| id | doaj-art-e6f29ef1b4a44c50a649fbeb6cb5a15f |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj-art-e6f29ef1b4a44c50a649fbeb6cb5a15f2025-01-07T06:41:26ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-01-011410.3389/fonc.2024.14307931430793Real-world experience with TTFields in glioma patients with emphasis on therapy usageClaudius Jelgersma0Joan Alsolivany1Gülsüm Akkas2David Wasilewski3David Wasilewski4Bastian Gastl5Martin Misch6David Capper7David Capper8David Kaul9David Kaul10Lars Bullinger11Lars Bullinger12Peter Vajkoczy13Julia Onken14Julia Onken15Julia Onken16Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, GermanyDepartment of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, GermanyDepartment of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, GermanyDepartment of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, GermanyGerman Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, GermanyNovocure GmbH, München, GermanyDepartment of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, GermanyGerman Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, GermanyDepartment of Neuropathology, Charité – Universitätsmedizin Berlin, Berlin, GermanyDepartment of Radiation Oncology and Radiotherapy Charité – Universitätsmedizin Berlin, Berlin, GermanyRadiation Therapy, Health and Medical University Potsdam, Potsdam, GermanyGerman Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, GermanyDepartment of Hematology, Oncology and Cancer Immunology, Charité – Universitätsmedizin Berlin, Berlin, GermanyDepartment of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, GermanyDepartment of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, GermanyGerman Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, GermanyBerlin Institute of Health at Charité, Universitätsmedizin Berlin, Berlin, GermanyTumor Treating Fields (TTFields) has emerged as a significant adjunctive component in the treatment of high-grade gliomas following the EF-14 trial in 2017. The incorporation of TTFields, alongside cyclic temozolomide therapy, has demonstrated improved patient outcomes when the usage exceeds 18 h per day (75% usage). Post-hoc analysis of the EF-14 trial has demonstrated that therapy usage exceeding 90% is associated with an additional benefit, while rates above 50% have also proven effective in literature. Given the cost-intensive nature and mild- to- moderate constraints associated with the therapy, our objective is to generate real-world data on therapy usage through a retrospective analysis at a high-throughput academic center. Between June 2015 and February 2022, a total of 113 high-grade glioma patients received TTFields therapy. Eight patients discontinued TTFields therapy within 2 months with less than 50% usage and were excluded from further analysis. For the remaining patients, the median age was 51 years (range: 20–76 years) and the mean preoperative Karnofsky index was 80%–90%. Most of the patients (75.2%) initiated therapy concurrently with first-line treatment, of whom 27.6% started TTFields therapy concomitant to the first cycle of temozolomide. 15.2% started TTFields therapy in the second-line and 9.5% in the third-line setting. The study cohort had an average therapy duration of 9.3 months with 3.2 break days per month. The mean therapy usage was 65.5% (SD 17.6%). Usage was highest during the first 3 months, with rates of 77.7%, 72.3%, and 71.6%, and then dropped to around 60% in the following 6 months. Linear regression found no predictors of usage, such as age, timing of therapy initiation, and duration or gender. 55% of patients continued TTFields beyond the first recurrence. Interestingly, no drop in usage rates was observed before tumor recurrence was communicated. However, after diagnosis, patients exhibited a significant drop in usage to an average of 52.3%. This high-volume, real-world TTFields usage data reveal that the extent of usage falls short of the intended 75%. It highlights the importance of monitoring and promoting adherence to maximize its potential benefits in managing high-grade glioma patients. Furthermore, strategies to expedite therapy initiation and improve long-term adherence are warranted.https://www.frontiersin.org/articles/10.3389/fonc.2024.1430793/fulltumor treating fields (TTFields)malignant gliomaglioblastomacomplianceusageadherence |
| spellingShingle | Claudius Jelgersma Joan Alsolivany Gülsüm Akkas David Wasilewski David Wasilewski Bastian Gastl Martin Misch David Capper David Capper David Kaul David Kaul Lars Bullinger Lars Bullinger Peter Vajkoczy Julia Onken Julia Onken Julia Onken Real-world experience with TTFields in glioma patients with emphasis on therapy usage Frontiers in Oncology tumor treating fields (TTFields) malignant glioma glioblastoma compliance usage adherence |
| title | Real-world experience with TTFields in glioma patients with emphasis on therapy usage |
| title_full | Real-world experience with TTFields in glioma patients with emphasis on therapy usage |
| title_fullStr | Real-world experience with TTFields in glioma patients with emphasis on therapy usage |
| title_full_unstemmed | Real-world experience with TTFields in glioma patients with emphasis on therapy usage |
| title_short | Real-world experience with TTFields in glioma patients with emphasis on therapy usage |
| title_sort | real world experience with ttfields in glioma patients with emphasis on therapy usage |
| topic | tumor treating fields (TTFields) malignant glioma glioblastoma compliance usage adherence |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1430793/full |
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