USC Explores Electric Fields Approach to Attack Deadliest Form of Brain Cancer
The study finds that using Tumor Treating Fields therapy (TTFields), which delivers targeted waves of electric fields directly into tumors to stop their growth and signal the body's immune system to attack cancerous tumor cells, may extend survival among patients with glioblastoma when combined with immunotherapy (pembrolizumab) and chemotherapy (temozolomide).
TTFields disrupt tumor growth using low-intensity, alternating electric fields that push and pull key structures inside tumor cells in continually shifting directions, making it difficult for the cells to multiply. Preventing tumor growth gives patients a better chance of successfully fighting the cancer. When used to treat glioblastoma, TTFields are delivered through a set of mesh electrodes that are strategically positioned on the scalp, generating fields at a precise frequency and intensity focused on the tumor. Patients wear the electrodes for approximately 18 hours a day.
Researchers observed that TTFields attract more tumor-fighting T cells, which are white blood cells that identify and attack cancer cells, into and around the glioblastoma. When followed by immunotherapy, these T cells stay active longer and are replaced by even stronger, more effective tumor-fighting T cells.
'By using TTFields with immunotherapy, we prime the body to mount an attack on the cancer, which enables the immunotherapy to have a meaningful effect in ways that it could not before,' said David Tran, MD, PhD, chief of neuro-oncology with Keck Medicine, co-director of the USC Brain Tumor Center and corresponding author of the study. 'Our findings suggest that TTFields may be the key to unlocking the value of immunotherapy in treating glioblastoma.'
TTFields are often combined with chemotherapy in cancer treatment. However, even with aggressive treatment, the prognosis for glioblastoma remains poor. Immunotherapy, while successful in many other cancer types, has also not proved effective for glioblastoma when used on its own.
However, in this study, adding immunotherapy to TTFields and chemotherapy was associated with a 70% increase in overall survival. Notably, patients with larger, unresected (not surgically removed) tumors showed an even stronger immune response to TTFields and lived even longer. This suggests that when it comes to kick-starting the body's immune response against the cancer, having a larger tumor may provide more targets for the therapy to work against.
This study demonstrates that combining TTFields with immunotherapy triggers a potent immune response within the tumor – one that ICIs can then amplify to bolster the body's own defense against cancer.
'Think of it like a team sport – immunotherapy sends players in to attack the tumor (the offense), while TTFields weaken the tumor's ability to fight back (the defense). And just like in team sports, the best defense is a good offense,' said Tran, who is also a member of the USC Norris Comprehensive Cancer Center.
Keck Medicine is participating in the multicenter Phase 3 clinical trial to validate the efficacy of TTFields with immunotherapy and chemotherapy. Tran, who has been researching TTFields for more than a decade, serves as the chair of the steering committee for this trial. Frances Chow, MD, neuro-oncologist with USC Norris, is the principal investigator of the Keck Medicine study site.
This Phase 3 trial, currently open at 28 sites across the United States, Europe and Israel, aims to enroll over 740 patients through April 2029, including those with gross total resection, partial resection or biopsy-only tumors to assess the extent of how surgically removing tumors influences immune response.
Information was sourced from Keck Medicine. To learn more, contact gabriella.robison@med.usc.edu.
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