NCOG-14. REAL-WORLD RETROSPECTIVE ANALYSIS OF TUMOR TREATING FIELDS IN THE TREATMENT OF HIGH-GRADE GLIOMA BASED ON CHINESE POPULATION

Abstract OBJECTIVES Tumor Treating Fields (TTFields) has been approved for the treatment of newly diagnosed and relapsed glioblastoma（GBM）in China in 2020. Only few TTFields data in Asia patients were reported. This retrospective analysis is aimed at investigating the efficacy, safety and the potential relationship with biomarkers of TTFields treatment in the real-world clinical practice of the Chinese glioma population. METHODS High-grade glioma patients who were under TTFields treatment from May 2019 to May 2021 in Shanghai Huashan Hospital were analyzed, including baseline data, efficacy data and incidence of adverse events. RESULTS Eighty-two patients (median age 51.0 [26.0 - 47.0] years) with high-grade glioma were enrolled, including 60 newly diagnosed GBM, 16 recurrent GBM, and 6 WHO grade III gliomas. The median time was 9.9 (4.6-15.7) months for follow-ups, median time for TTFields treatment was 4.3(1.1-20.35) months. The median compliance rate was 90% (40%-97%). For newly diagnosed GBM (n=60) and recurrent GBM (n=16), the 6-month PFS rate were 78.4% (95%CI: 63.9-87.6) and 46.7% (95%CI: 21.2- 67.8) respectively. The 10-month OS rate were 86.3% (95%CI: 69.6- 94.2) and 60.0% (95%CI: 12.6- 88.2) respectively. The 6-month PFS rate in the IDHw/TERTm population was 69.9% (95%CI: 45.9-84.9) and 78.3% (95%CI: 46.5-92.5) in the IDHw/TERTw patients with newly diagnosed GBM. 59(72%) patients had skin-related adverse reactions, and majority are grade 1-2 (grade 1-2, 69.5%; grade 3, 2.5%). CONCLUSIONS This is the 1st retrospective analysis done using TTFields in the treatment of high-grade gliomas in the Chinese population with the largest sample size. From our short follow up, TTFields appears good efficacy among GBM patients. The incidence of skin adverse reactions is higher comparable to published data, but mainly consisted of grade1-2. Long-term efficacy data need to be further followed-up.

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Dabrafenib With Trametinib After Radiation Therapy in Treating Patients With Newly-Diagnosed BRAF V600-Mutant High-Grade Glioma

Case Medical Research ◽

10.31525/ct1-nct03919071 ◽

2019 ◽

Author(s):

Keyword(s):

Radiation Therapy ◽

High Grade Glioma ◽

High Grade ◽

Newly Diagnosed

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Direct medical costs of treatment in newly-diagnosed high-grade glioma among commercially insured US patients

Journal of Medical Economics ◽

10.1080/13696998.2017.1364258 ◽

2017 ◽

Vol 20 (12) ◽

pp. 1237-1243 ◽

Cited By ~ 3

Author(s):

Shan Jiang ◽

Kala Hill ◽

Dipen Patel ◽

A. Reginald Waldeck ◽

Marc Botteman ◽

...

Keyword(s):

High Grade Glioma ◽

Medical Costs ◽

High Grade ◽

Newly Diagnosed ◽

Direct Medical Costs ◽

Costs Of Treatment

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Central neurotoxicity of standard treatment in patients with newly-diagnosed high-grade glioma: a prospective longitudinal study

Journal of Neuro-Oncology ◽

10.1007/s11060-013-1310-4 ◽

2013 ◽

Vol 116 (2) ◽

pp. 387-394 ◽

Cited By ~ 22

Author(s):

F. E. Froklage ◽

L. J. Oosterbaan ◽

E. M. Sizoo ◽

M. de Groot ◽

I. Bosma ◽

...

Keyword(s):

Longitudinal Study ◽

Standard Treatment ◽

High Grade Glioma ◽

High Grade ◽

Newly Diagnosed ◽

Prospective Longitudinal Study ◽

Central Neurotoxicity ◽

Prospective Longitudinal

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CTNI-52. RETROSPECTIVE ANALYSIS OF USING RADIOTHERAPY WITH CONCURRENT TEMOZOLOMIDE AND TUMOR TREATING FIELDS FOR CHINESE PATIENTS WITH NEWLY DIAGNOSED GLIOBLASTOMA

Neuro-Oncology ◽

10.1093/neuonc/noab196.277 ◽

2021 ◽

Vol 23 (Supplement_6) ◽

pp. vi72-vi72

Author(s):

Yang Wang ◽

Jingsong Wu ◽

Zhiyong Qin ◽

Enmin Wang ◽

Yu Yao ◽

...

Keyword(s):

Combination Therapy ◽

Adverse Reactions ◽

Treatment Time ◽

Synergistic Effects ◽

Chinese Patients ◽

Newly Diagnosed ◽

Transducer Array ◽

Nccn Guidelines ◽

Tumor Treating Fields ◽

Cutaneous Adverse Reactions

Abstract OBJECTIVES Tumor Treating Fields (TTFields) has been shown to improve the overall survival of newly diagnosed GBM (ndGBM) when combined with Temozolomide (TMZ) in the EF-14 trial. Preclinical studies suggested synergistic effects between TTFields and radiotherapy. This study is aimed to examine the safety and efficacy of combination therapy (chemoradiation concurrent with TTFields treatment) for ndGBM patients in China. METHODS From July 2020 to May 2021, 33 ndGBM patients were treated with combination therapy (radiation target volume following NCCN guidelines). Eight patients had transducer array removed during radiotherapy, others retained transducer array on scalp. All patients had assessment every two months by MRI scan. The adverse reactions and monthly compliance data for TTFields treatment were recorded. RESULTS Twenty-five patients have completed the combination therapy. Three patients retained transducer array during radiotherapy but did not limit the scalp dose (mean: 21.7Gy). As a result, Grade 2 cutaneous adverse reactions developed, and TTFields treatment was suspended. Four patients suspended TTFields treatment due to other adverse reactions. The remaining patients who had limited scalp doses (mean < 20Gy) had no suspension or delay in combination therapy due to cutaneous adverse reactions. The median time of TTFields treatment during radiotherapy is 21.24 hours/day (IQR:19.26,22.08). Two patients had progressive disease, 1 died of pulmonary infection, and 30 had stable disease. The incidence of cutaneous AE was 48.5% (16/33), Grade1: 27.2% (9/33), Grade 2: 21.2% (7/33), and Grade 3: 3% (1/33). CONCLUSIONS The combination therapy was well tolerated in Chinese patients with ndGBM. Removing transducer array during radiotherapy may increase the frequency of array replacement while reducing the patient's daily treatment time. However, retaining transducer array will increase cutaneous adverse reactions. Scalp dose limitation is required yet it allows a maximum duration of TTFields. Further follow-ups are ongoing.

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P04.22 Tumor treating fields in high-grade glioma patients: A retrospective single-center study

Neuro-Oncology ◽

10.1093/neuonc/noab180.075 ◽

2021 ◽

Vol 23 (Supplement_2) ◽

pp. ii23-ii23

Author(s):

R Lucaciu ◽

B Suchorska ◽

M Wettig ◽

S Jung ◽

M Scholz

Keyword(s):

Promoter Methylation ◽

Daily Life ◽

Methylation Status ◽

Mgmt Promoter Methylation ◽

Therapeutic Modality ◽

High Grade ◽

Newly Diagnosed ◽

Non Invasive ◽

Tumor Treating Fields ◽

Mgmt Promoter

Abstract BACKGROUND Tumor-treating fields (TTFields) are a modern anti-mitotic, non-invasive therapy for the treatment of patients with recurrent and newly diagnosed glioblastoma multiforme (GBM). In Europe, Optune® recieved in 2015 the CE certification. TTFields are a low-intensity (1–3 V/cm) approved therapeutic modality using a non-invasive application of intermediate frequency (200 kHz) alternating electric fields through four transducer arrays directly applied to the skin. The EF-14 study has shown that the addition of TTFields to temozolomide chemotherapy in patients with newly diagnosed GBM significantly improved overall survival (OS) and progression-free survival (PFS) without additional adverse events, apart from mild to moderate skin irritations (Stupp et al., JAMA 2017). MATERIAL We retrospectively analyzed data from TTFields-treated patients (2015–2020) that were treated at our department. Patient characteristics such as MGMT promoter methylation status, age, and diagnosis, as well as treatment duration and TTFields therapy usage, were evaluated for this study. RESULTS 29 patients were treated with TTFields therapy between 2015 and 2020 at our hospital. Most patients received TTFields as primary treatment together with temozolomide maintenance therapy. In detail, 48% of patients were diagnosed with newly diagnosed GBM, 41% received TTFields therapy after tumor recurrence and 10% were diagnosed with other high-grade gliomas. In summary, patients could integrate TTFields therapy into their daily life and showed high adherence to the therapy.Particularly, one of our patients (with MGMT-promoter methylation positive) receives TTFields therapy now for almost 1229 days (approx. 41 months) and is still on therapy. Additionally, this patient shows a high usage rate of 86% indicating well integration of the therapy into daily life. CONCLUSION Taken together, our data provided the outcomes of using TTFields together with chemotherapy in the treatment of recurrent and newly diagnosed GBM in our department. Therapy with TTFields has been showing to provide significant clinical benefit for GBM patients.

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