Head and neck cancer

Scepticism over electric field therapy for glioblastoma


A controversial anti-mitotic treatment using electric fields to disrupt glioblastoma cell division has been shown to improve survival in an open label, phase 3 trial.

The study, published in JAMA, comprised 695 patients with glioblastoma following resection and initial radiochemotherapy.

Patients were randomised to either maintenance temozolomide alone or in combination with low dose, alternating electric fields (‘Tumour Treating Fields’) delivered to their scalp.

 

Typically six cycles of temozolomide were given before tumour progression. The median duration of the tumour-treating electric fields therapy was eight months.

A small number of patients crossed over to receive the new therapy after positive interim results were delivered in 2014.

The study found progression-free survival improved by more than two months with the tumour-treating fields therapy compared to temozolomide alone (6.7 v 4 months). Overall survival was also extended by almost five months (20.9 v 16 months).

Rates of systemic adverse effects were similar in both patient groups.

“These findings are in contrast to the more than 23 randomized trials conducted over the last decade that have evaluated novel agents or intensified treatment strategies (eg, dose-dense temozolomide, cilengitide, nimotuzumab, bevacizumab, and rindopepimut) for treatment of patients with newly diagnosed glioblastoma and have failed to demonstrate improved survival,” the researchers from centres in Chicago and Switzerland said.

“Innovative treatments for glioblastoma are needed.”

However medical oncologist Professor Mark Rosenthal from the Peter MacCallum Cancer Centre, suggested theTumour Treating Fields therapy was not yet the answer and was not going to help many Australian patients with glioblastoma.

“As far as I am aware, this is not available in Australia and patients who wish to undergo such therapy must travel overseas every month. The cost is prohibitive.”

“Internationally and in Australia there is significant scepticism about this treatment although the principle investigator (Roger Stupp) is highly regarded.”

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