Tumor Treating Fields
||It has been suggested that this article be merged into Electromagnetic therapy (alternative medicine). (Discuss) Proposed since December 2013.|
Tumor Treating Fields (sometimes abbreviated as TTF) is a neologism used to describe a type of electromagnetic field therapy using low-intensity electrical fields. Devices marketed by the Israeli company Novocure generate such fields and are promoted for the treatment of specific cancers.
Research has found that people with a form of recurrent brain cancer treated with TTFs responded similarly to those treated with standard chemotherapy, having a mean survival time of 6 months. Side effects from TTF use are different from those of chemotherapy: rashes from electrode use rather than blood and digestive problems.
The devices generate electromagnetic waves between 100 and 300 kHz; the proposed mechanism of action is that the these fields interfere with cancer cells during cell division. The fields can be used in conjunction with regular patterns of care for patients. When a TTF device is used, electrodes are placed onto a patient's scalp that resemble a kind of "electric hat". When not in use, the devices are plugged into a power outlet to be re-charged.
Approval and efficacy
A TTF device was approved by the U.S. Food and Drug Administration (FDA) in April 2011, despite what Medical Device Daily reported as "huge misgivings on several points". The pleas of cancer patients in the room of the FDA hearing swayed the opinions of many during the related FDA panel. It had undergone clinical trials for its effectiveness in the treatment of recurring glioblastoma multiforme (GBM), and these trials had reported its effect was on a par with existing treatment, achieving a mean survival time of approximately 6 months. The trials were criticized for their statistical methodology and for their unreported inclusion of conventional cancer drugs, including Avastin.
A 2013 systematic review of the evidence of tumor treating fields' effectiveness found a high-quality randomized control trial of the treatment showing it was as beneficial to people with cancer as standard chemotherapy, but had different side effects. The adverse effects of TTF were topical skin rashes caused by electrode use; whereas standard chemotherapy causes severe nausea, weight loss, digestive and blood problems,and hair loss.  The relative harms of those effects could be balanced according to the choice of the person being treated. Although other studies had suggested the fields were beneficial, those results were viewed with caution because the studies were poorly designed. The review recommended more studies to be undertaken looking at specific patient attitudes towards use of the TTF devices.
- Novocure website Page about delivery method
- Calzón Fernández S, Llanos Méndez A (2013). Tumor treating fields therapy (TTF) for glioblastoma. A systematic review of the literature (Systematic review) (in Spanish). Agencia de Evaluación de Tecnologías Sanitarias de Andalucía. ISBN 978-84-15600-12-1.
- "NovoCure wins nod from panel despite trial, statistical miscues". Medical Device Daily. 21 March 2011 – via Highbeam.
- "NCCN Guidelines for CNS cancers" (pdf). Retrieved August 2013.
- Davies, Angela M.; Weinberg, Uri; Palti, Yoram (2013). "Tumor treating fields: A new frontier in cancer therapy". Annals of the New York Academy of Sciences 1291 (1): 86–95. doi:10.1111/nyas.12112. PMID 23659608.
- Kirson et al.; Gurvich, Z; Schneiderman, R; Dekel, E; Itzhaki, A; Wasserman, Y; Schatzberger, R; Palti, Y (2004). "Disruption of Cancer Cell Replication by Alternating Electric Fields". Cancer Research 64 (9): 3288–95. doi:10.1158/0008-5472.CAN-04-0083. PMID 15126372.
- Kirson et al.; Dbaly, V.; Tovarys, F.; Vymazal, J.; Soustiel, J. F.; Itzhaki, A.; Mordechovich, D.; Steinberg-Shapira, S. et al. (2007). "Alternating electric fields arrest cell proliferation in animal tumor models and human brain tumors". PNAS 104 (24): 10152–7. doi:10.1073/pnas.0702916104. PMC 1886002. PMID 17551011.
- Stupp et al. (2010). "A prospective, randomized, open-label, phase III clinical trial of NovoTTF-100A versus best standard of care chemotherapy in patients with recurrent glioblastoma". Journal of Clinical Oncology 28.
- Kirson et al. (2010). "A phase II study of tumor treating fields (TTFields) in combination with pemetrexed for advanced non small cell lung cancer (NSCLC)". Ann Oncol 64: viii122. doi:10.1093/annonc/mdq518.
- Treating cancer with electric fields Bill Doyle TED talk
- Can an Electric Hat Fight Tumors? comment in Science
- Alternating electric fields disrupt glioblastoma tumor growth in pilot study comment in Nature Clinical Practice Neurology
- Approval acknowledgement from FDA