Abstract
The standard of care for patients with newly diagnosed Glioblastoma multiforme (GBM) has remained unchanged since 2005, with patients undergoing maximal surgical resection, followed by radiotherapy plus concomitant and maintenance Temozolomide. More recently, Tumour treating fields (TTFields) therapy has become FDA approved for adult recurrent and adult newly-diagnosed GBM following the EF-11 and EF-14 trials, respectively. TTFields is a non-invasive anticancer treatment which utilizes medium frequency alternating electric fields to target actively dividing cancerous cells. TTFields selectively targets cells within mitosis through interacting with key mitotic proteins to cause mitotic arrest and cell death. TTFields therapy presents itself as a candidate for the combinational therapy route due to the lack of overlapping toxicities associated with electric fields. Here we review current literature pertaining to TTFields in combination with alkylating agents, radiation, anti-angiogenics, mitotic inhibitors, immunotherapies, and also with novel agents. This review highlights the observed synergistic and additive effects of combining TTFields with various other therapies, as well highlighting the strategies relating to combinations with electric fields.
Highlights
The use of electric fields for the treatment of neurological disorders pre-dates its use in the treatment of glioma [1]
TTFields therapy presents itself as a candidate for the combinational therapy route due to the lack of overlapping toxicities associated with electric fields
TTFields efficacy has been shown in a large phase III trial to be comparable to best physician’s choice chemotherapy (BPC) chemotherapies, including Bevacizumab (31% of patients), but without a diverse and adverse effects profile akin to conventional chemotherapies [34]
Summary
The use of electric fields for the treatment of neurological disorders pre-dates its use in the treatment of glioma [1]. Tumour treating fields (TTFields) therapy has become FDA approved for adult recurrent and adult newly-diagnosed GBM following the EF11 and EF-14 trials, respectively. Optune therapy was more recently tested in a Phase III trial for newly-diagnosed GBM patients after receiving their initial treatment as per the Stupp protocol [3].
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