Tumor Treating Fields for Locally Advanced Pancreatic Cancer

Tumor treating fields (TTF) is a noninvasive therapy that uses alternating low-intensity electric fields to inhibit cancer cell proliferation. Now, investigators report treatment outcomes in patients with locally advanced unresectable pancreatic adenocarcinoma who received gemcitabine and nab-paclitaxel with or without TTF in an industry-sponsored, open-label phase 3 global trial. Of the 571 participants, most had tumors of the pancreatic head (51%) or body (28%). Nearly half (43%) received treatment in North America, 58% were ECOG PS 1, and only 4% were ECOG 2.

Overall survival (OS) was significantly lengthened with the addition of TTF to chemotherapy over chemotherapy alone (median, 16.2 months vs. 14.2 months; hazard ratio, 0.82), with no significant difference in progression-free survival (PFS; range, 9.3–10.6 months). Although local PFS did not differ appreciably between groups, distant PFS was significantly extended when TTF was added to chemotherapy (13.9 months vs. 11.5 months; HR, 0.74). Pain-free survival was also significantly improved with TTF (15.2 months vs. 9.1 months; HR, 0.74). The most common device-related adverse events — dermatitis, rash, and pruritus — occurred in up to 28% of patients.