Tumor treating fields (TTFields) therapy in patients with glioblastoma: Long-term survival results from TTFields in Germany in routine clinical care (TIGER) study.

person Oliver Bähr General Hospital Aschaffenburg-Alzenau, Department of Neurology, Aschaffenburg, Germany info_outline Oliver Bähr, Ghazaleh Tabatabai, Rainer Fietkau, Roland Goldbrunner, Martin Glas

Authors person Oliver Bähr General Hospital Aschaffenburg-Alzenau, Department of Neurology, Aschaffenburg, Germany info_outline Oliver Bähr, Ghazaleh Tabatabai, Rainer Fietkau, Roland Goldbrunner, Martin Glas Organizations General Hospital Aschaffenburg-Alzenau, Department of Neurology, Aschaffenburg, Germany, University Hospital Tübingen, Department of Neurology and Interdisciplinary Neurooncology, Tübingen, Germany, University Hospital Erlangen, Department of Radiation Oncology, Erlangen, Germany, University Hospital Cologne, Center for Neurosurgery, Köln, Germany, Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, West German Cancer Center (WTZ), and German Cancer Consortium, Partner Site, Essen, Germany Abstract Disclosures Research Funding Novocure, Inc Background: Tumor Treating Fields (TTFields) therapy has demonstrated significant improvements in overall survival (OS) and progression-free survival (PFS) when applied with adjuvant temozolomide (TMZ) compared to TMZ alone in newly diagnosed glioblastoma (ndGBM). TTFields therapy delivers electric fields, through scalp-placed arrays, that disrupt cellular processes critical for cancer cell viability, is CE marked for WHO grade 4 glioma, and is a recommended treatment regimen for ndGBM. TTFields therapy was administered to >25,000 patients, showing no systemic toxicities and mild to moderate skin reactions being the main therapy-related adverse event. Here, we report survival and safety data from the TIGER study, the largest prospective study investigating real-world use of TTFields therapy during routine clinical care in patients with ndGBM in Germany. Methods: TIGER (NCT03258021), a prospective, non-interventional, multicenter, medical device study, screened patients ≥18 years of age with histologically confirmed ndGMB from August 2017 to November 2019 in 81 participating centers in Germany who had clinical indication for TTFields therapy and were within the first 3 cycles of maintenance chemotherapy treatment. The analysis presented here focuses on patients that accepted TTFields therapy. Endpoints included OS, PFS, safety, and quality of life. Results: In this study, 710 assessed patients agreed to participate, with 583 (82%) opting for TTFields therapy, and 429 actually commencing the treatment. This patient population represents typical GBM patients, with a median age of 58 (range 19–82) and 64.1% being male. After a total follow-up of 56.2 months, the median OS and PFS were 19.6 months (95% CI, 17.9–22.4) and 10.2 months (95% CI, 9.4–11.4), respectively. The corresponding 1, 2, 3, and 4-year OS rates stood at 79.2%, 42.4%, 31.5%, and 27.7%, while the PFS rates were 42.0%, 23.2%, 19.9%, and 17.6%, respectively. Serious AEs were observed in 68% of patients, with only 0.5% being attributed to TTFields therapy. Conclusions: TIGER is the largest prospective study to date on routine clinical practice in ndGBM. It reaffirms TTFields therapy’s positive safety profile, and its OS and PFS survival benefits are consistent with prior reports. It also reveals promising long-term survival rates. Clinical trial information: NCT03258021.

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