Quality of Life in Glioblastoma Not Worsened by Tumor-Treating Fields Plus Temozolomide

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TTFields therapy was associated with significantly greater physical and emotional functioning.
TTFields therapy was associated with significantly greater physical and emotional functioning.

Tumor-treating fields (TTFields) therapy with temozolomide does not have a negative impact on health-related quality of life (HRQoL) in patients with glioblastoma when compared with temozolomide only, according to study findings published in JAMA Oncology.

Non-invasive TTFields therapy generates alternating electric fields of low intensity that are delivered through wired transducer arrays on the patient's scalp. These low-intensity electric fields rely on physical molecular reactions to disrupt cell division in solid tumor carcinomas.

In this secondary analysis of a phase 3, randomized clinical trial, investigators compared outcomes in patients with glioblastoma receiving either TTFields plus temozolomide (n=466) or temozolomide only (n=229) after radiochemotherapy. The primary end point was progression-free survival at follow-up. Additionally, investigators administered questionnaires to patients at baseline and every 3 months to assess for changes in HRQoL.

Patients receiving TTFields carried a portable medical device that delivered continuous electric fields through 4 transducer arrays that were attached to the patient's shaved scalp. Doses of temozolomide were between 150 and 200 mg/m2 per day for a total of 5 days during 28-day treatment cycles.

Participants receiving TTFields with temozolomide experienced a significantly longer deterioration-free survival for global health vs those receiving temozolomide only (4.8 vs 3.3 months, respectively; P <.01). In addition, TTFields therapy was associated with significantly greater physical (5.1 vs 3.7 months; P <.01) and emotional functioning (5.3 vs 3.9 months; P <.01) as well as significantly greater improvements in pain (5.6 vs 3.6 months; P <.01) and leg weakness (5.6 vs 3.9 months; P <.01). Although there was no difference between the 2 groups in time to deterioration, participants randomly assigned to TTFields experienced more incidences of itchy skin (8.2 vs 14.4 months; P <.001) and greater improvements in pain (13.4 vs 12.1 months; P <.01).

Because investigators of this study focused solely on patients who had completed radiochemotherapy, the findings may not generalize to the entire population of people with glioblastoma. Additionally, some of the HRQoL data were missing in the final evaluation, which the researchers suggest limited the longitudinal analysis.

The findings from this study demonstrate that the improved survival benefit and lack of a negative influence on HRQoL with TTFields therapy “supports the addition of tumor-treating fields to standard treatment in patients with glioblastoma.”

Reference

Taphoorn MJB, Dirven L, Kanner AA, et al. Influence of treatment with tumor-treating fields on health-related quality of life of patients with newly diagnosed glioblastoma: a secondary analysis of a randomized clinical trial [published online February 1, 2018]. JAMA Oncol. doi: 10.1001/jamaoncol.2017.5082

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