Glioblastoma multiforme (GBM) is the most common primary brain tumour in adults and continues to portend poor survival, despite multimodal treatment using surgery and chemoradiotherapy. The addition of tumour-treating fields (TTFields)-an approach in which alternating electrical fields exert biophysical force on charged and polarisable molecules known as dipoles-to standard therapy, has been shown to extend survival for patients with newly diagnosed GBM, recurrent GBM and mesothelioma, leading to the clinical approval of this approach by the FDA.
Review Br J Cancer 2021 Feb;124(4):697-709. doi: 10.1038/s41416-020-01136-5. Epub 2020 Nov 4.
Tumour treating fields therapy for glioblastoma: current advances and future directions
Ola Rominiyi # 1 2, Aurelie Vanderlinden # 3, Susan Jane Clenton 4, Caroline Bridgewater 4, Yahia Al-Tamimi 5, Spencer James Collis 6Affiliations expand
- PMID: 33144698
- PMCID: PMC7884384
- DOI: 10.1038/s41416-020-01136-5
Free PMC article
Erratum in
- Correction: Tumour treating fields therapy for glioblastoma: current advances and future directions.Rominiyi O, Vanderlinden A, Clenton SJ, Bridgewater C, Al-Tamimi Y, Collis SJ.Br J Cancer. 2021 Aug;125(4):623. doi: 10.1038/s41416-021-01451-5.PMID: 34112950 Free PMC article. No abstract available.
Abstract
Glioblastoma multiforme (GBM) is the most common primary brain tumour in adults and continues to portend poor survival, despite multimodal treatment using surgery and chemoradiotherapy. The addition of tumour-treating fields (TTFields)-an approach in which alternating electrical fields exert biophysical force on charged and polarisable molecules known as dipoles-to standard therapy, has been shown to extend survival for patients with newly diagnosed GBM, recurrent GBM and mesothelioma, leading to the clinical approval of this approach by the FDA. TTFields represent a non-invasive anticancer modality consisting of low-intensity (1-3 V/cm), intermediate-frequency (100-300 kHz), alternating electric fields delivered via cutaneous transducer arrays configured to provide optimal tumour-site coverage. Although TTFields were initially demonstrated to inhibit cancer cell proliferation by interfering with mitotic apparatus, it is becoming increasingly clear that TTFields show a broad mechanism of action by disrupting a multitude of biological processes, including DNA repair, cell permeability and immunological responses, to elicit therapeutic effects. This review describes advances in our current understanding of the mechanisms by which TTFields mediate anticancer effects. Additionally, we summarise the landscape of TTFields clinical trials across various cancers and consider how emerging preclinical data might inform future clinical applications for TTFields.
Conflict of interest statement
O.R. and S.p.J.C. are recipients of an Inovitro™ system (on loan from Novocure) and take part in the annual Inovitro™ Users Meeting hosted by Novocure. The remaining authors declare no competing interests.
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References
- Philips A, Henshaw DL, Lamburn G, O’Carroll MJ. Brain tumours: rise in glioblastoma multiforme incidence in England 1995-2015 suggests an adverse environmental or lifestyle factor. J. Environ. Public Health v. 2018;2018:7910754. – PMC – PubMed
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