A breakthrough in prolonging survival in patients with glioblastoma appears to be at hand. The combination of tumor-treating fields (TTFields) and temozolomide resulted in significantly longer progression-free survival and overall survival than temozolomide alone in an international randomized clinical trial.1
Most patients die within 1 to 2 years of a glioblastoma diagnosis, with 5-year survival rates at only 5% to 10% despite aggressive treatment with surgical resection, high-dose external-beam radiation therapy, and chemotherapy.2 The current study, conducted by an international team of researchers and lead by Roger Stupp, MD, professor and chairman of the Department of Oncology at the University of Zurich, Switzerland, may offer an opening for progress; namely, longer survival.
“This study marks a true milestone in the treatment of brain tumors and cancer in general,” Professor Stupp told Neurology Advisor. “Ten years ago we demonstrated that combining chemotherapy with irradiation improves patient outcomes and quality of life.2 We now establish that the addition of this entirely novel treatment modality further improves progression-free and overall survival in patients with brain tumors when used early in the disease course.”
According to Professor Stupp and colleagues, TTFields therapy is an antimitotic treatment that interferes with cell division and organelle assembly. It involves delivery of low-intensity intermediate-frequency alternating electric fields to the tumor site, which are thought to disrupt spindle formation during cell division, resulting in mitotic arrest.
Of the 695 patients enrolled in the trial, 466 were randomized to receive maintenance TTFields and temozolomide and 299 received temozolomide alone. The primary endpoint was progression-free survival and the secondary was overall survival. All patients had already completed standard chemoradiotherapy for newly diagnosed supratentorial glioblastoma and were free of evidence of tumor progression upon study enrollment. The median time from diagnosis to study randomization was 3.8 months. Reported was the outcome of an interim analysis on the first 315 patients randomized for whom a minimum follow-up of 18 months (median follow-up 38 months) was available.