Tumor treating fields



Also known as alternating electric field therapy.

TTF uses electromagnetic waves.

Exerts dielectrophoretic forces on cellular components, altering normal functions.

TTF are low intensity, intermediate frequency, alternating electrical fields, delivered via a device, that physically interferes with cell division, by causing misalignment of the microtubule subunits in the mitotic spindle during the metaphase to anaphase transition, and by dielectrophoretic movement of intracellular, macromolecules and organelles during telophase.

Alternating electric field disrupts the movement of charged particles.

The human body has many charged molecules that have zero net charge.

Molecules have a positive charge on 1 end and a negative charge on the other.

Alternating electric field results and no net translational with movement, but there is rotational movement.

The dipole moves around because of the alternating alternating electric field with the charged environment imposed onto the dipole.

A type of electromagnetic field therapy using low-intensity electrical fields to treat cancer.

Optune system approved in US.

TTF approved for the treatment of Glioblastoma multiforme and Mesothelioma when combined with chemotherapy.

TTF does not disrupt electrons.

Disrupts mitosis during the metaphase to anaphase transition.

Errors that develop in the late metaphase or anaphase result in cell death.

TTF inhibits cytokinesis at the end of mitosis in which a cell with 2 nuclei separates into 2 cells.

TTF relies on the generation of an alternating current that disrupts mitotic spindle assembly and is reported to trigger adaptive immunity.

A TTF-generating device manufactured by Novocure is approved in the United States and Europe for the treatment of recurrent glioblastoma multiforme (GBM), and is undergoing clinical trials for several other tumor types.

Efficacy of this technology remains controversial among medical experts.

Does not stimulate nerves are muscles and does not affect rapidly proliferating cells and the rest of the body.

Alternating electric field therapy / TTF uses insulated electrodes to apply very-low-intensity, intermediate-frequency alternating electrical fields to a target area containing proliferating cells.

In preclinical cancer models, it show selective toxicity to proliferating cells through an antimitotic mechanism.

This approach could be selective for cancer cells in regions of the body, such at the brain, where the majority of normal cells are non-proliferating.

This treatment generates electromagnetic waves between 100 and 300 kHz.

These waves affect molecules that have a particular dipole moment and include septin and probably other large molecules.

Septin is a large protein responsible for demarcating where cells separate, and its location is pertubed by TTF.

Septin has a large dipole moment making it susceptible to to electric field disruption.

Septin dislodgement by TTF leads to scatter into cell membranes with microtubule disruption and chromsomal segregation during mitosis and subsequent cell death.

Interferes with electrostatic charges involved in binding proteins such as tubulin and to the chromosome, preventing equal division of genetic material.

Leads to cellular death by apoptosis.

The devices can be used in conjunction with regular modes of therapy.

Electrodes resembling a kind of electric hat are placed onto a patient’s shaved scalp.

In a clinical trial of newly diagnosed patients with glioblastoma multiforme, showed a statistically significant benefit in median survival for patients treated with TTF plus conventional therapy (temozolomide, radiation, and surgery) versus patients treated with conventional therapy alone.

TTF in heavily pretreated glioblastoma multiforme patients has efficacy at least equivalent to that of chemotherapy.

The adverse effects of TTF included topical skin rashes caused by electrode use.

A randomized phase 3 trial reported a 3 month survival advantage as well as 3 month progression free survival advantage.

The device benefits those most who wear the device at least 75% of the time.

TTF works only when the device is being worn.

In treating glioblastoma low-dose dexamethasone is pref2242ed over higher doses as drug inhibits immunodiffusion and benefits in TPF patients.

Five-year survival analysis of 695 patients significantly improved overall survival and progression free survival of the use of tumor treatment fields and temozolomide in glioblastoma multiforme: median overall survival: 20.9 months versus 16 months with temozolomide alone and a medium progression free survival of 6.7 months versus four months with temozolomide alone.

The US Food and Drug Administration (FDA) has approved a tumor treating fields (TTF) device in combination with pemetrexed plus platinum-based chemotherapy for the first-line treatment of unresectable, locally advanced or metastatic, malignant pleural mesothelioma.(Novocure)

TTF therapy uses electric fields to disrupt solid tumor cancer cell division.

Previously, the FDA approved Optune, another TTF delivery system from Novocure, for the treatment of glioblastoma in 2011.

The FDA approval is based on the results of the STELLAR trial, a prospective, single-arm trial of NovoTTF-100L plus chemotherapy first-line in patients with unresectable malignant pleural mesothelioma.

In the trial, 80 unresectable malignant plueural mesothelioma patients treated with TTF plus chemotherapy experienced a median overall survival (OS) of 18.2 months.




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