A general approach to optimizing tumor treating fields therapy.

person Zeev Bomzon Novocure Ltd., Haifa, Israel info_outline Zeev Bomzon, Noa Urman, Hadas Sara Hershkovich, Eilon David Kirson, Ariel Naveh, Reuven Shamir, Eduard Federov, Cornelia Wenger, Uri Weinberg

Authors person Zeev Bomzon Novocure Ltd., Haifa, Israel info_outline Zeev Bomzon, Noa Urman, Hadas Sara Hershkovich, Eilon David Kirson, Ariel Naveh, Reuven Shamir, Eduard Federov, Cornelia Wenger, Uri Weinberg Organizations Novocure Ltd., Haifa, Israel, NovoCure, Haifa, Israel, Novocure, Haifa, Israel, Novocure Gmbh, Lucerne, Switzerland Abstract Disclosures Research Funding Other Background: Tumor Treating Fields (TTFields) are alternating electric fields used to non-invasively treat cancer. TTFields are delivered via transducer arrays placed on the skin close to the tumor. Post-hoc analysis [1] has shown that delivering higher field power to the tumor and increasing usage (percent of time patient is actively treated) improve patient survival. Thus, optimizing the position of arrays to maximize TTFields power at the tumor could improve survival. At the same time, minimizing the array area to maximize patient comfort and consequently maximizing usage is also likely to improve survival. However, optimizing TTFields delivery is non-trivial since the field distribution is influenced by array positioning and geometry, the anatomy of the patient and the heterogeneous electric properties of different tissues. Here we present a general approach to optimizing Tumor Treating Fields using numerical simulations. Methods: Delivery of TTFields to the brains, lungs and abdomens of realistic computational models was investigated. The effect of the transducer array size and position on the field distribution within the phantoms was analyzed, and an approach for optimizing TTFields delivery developed. Results: Field power is generally highest in the region between the arrays, with larger arrays generally delivering higher field power. Anatomical features such as bones, the spine or a resection cavity significantly influence the field within this region. A general approach to optimizing TTFields delivery is: Maximize field power by using the largest arrays possible. To maximize patient comfort, array size are chose so that significant portions of the skin in the region of disease are not covered by the arrays. Place virtual arrays on a realistic computational model of the patient such that the tumor is located between them and simulate TTFields delivery to the patient. Apply an iterative algorithm to shift the arrays around their initial positions until field power in the tumor bed is maximized. Conclusions: We have developed a general approach to optimizing delivery of TTFields to the tumor. Effective TTFields treatment planning is expected to improve patient outcome. [1] Ballo et. al., submitted to RED Journal 2018.