Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Apr 8;13(2):151-165.
doi: 10.3390/neurolint13020015.

Tumor-Treating Fields Therapy for Pediatric Brain Tumors

Atsushi Makimoto  1   2 , Ryo Nishikawa  3 , Keita Terashima  4 , Jun Kurihara  5 , Hiroyuki Fujisaki  6 , Satoshi Ihara  7 , Yoshihiko Morikawa  2 , Yuki Yuza  1
Affiliations
Review

Tumor-Treating Fields Therapy for Pediatric Brain Tumors

Atsushi Makimoto et al. Neurol Int. .

Abstract

Tumor-treating fields (TTFields) are alternating electric fields applied continuously to the brain by attaching two-pair arrays on the scalp. Although TTFields therapy has demonstrated efficacy against supratentorial glioblastoma (GBM) in adults, its safety and efficacy in children have not been confirmed. Despite differences in the genetic etiology of the adult and pediatric forms of GBM, both have certain clinical behaviors in common, allowing us to test TTFields therapy in pediatric GBM. Recently, several, pediatric case-series using TTFields therapy have been published, and a few, prospective, pediatric studies are ongoing. Because GBMs are extremely rare in pediatric patients, where they comprise a wide variety of genetic subtypes, these pediatric studies are feasibility studies targeting various types of malignant brain tumor. Although they are important for confirming the safety and feasibility of TTFields therapy in the pediatric population, confirming its efficacy against each type of pediatric brain tumor, including the GBM, is difficult. Our clinical research team, therefore, planned an investigator-initiated clinical trial targeting pediatric supratentorial GBMs (as in adults) with the aim of expanding regulatory approval of TTFields therapy for pediatric GBM treatment based on safety and exploratory efficacy data in combination with the accumulated evidence on adult GBMs.

Keywords: TTFields; clinical trial; glioblastoma; pediatric brain tumors; tumor-treating fields.

PubMed Disclaimer

Conflict of interest statement

Nishikawa (R.N.) reports receiving advisory board fees from Novocure, Ltd. The other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Mechanism of action of TTFields therapy. The TTFields exert directional forces on polar microtubules, interfere with the assembly of the normal mitotic spindle and subsequently trigger mitotic cell death. TTFields also inhibit DNA damage repair, impair cellular migration and upregulate autophagy, resulting in immunogenic cell death. Reproduced with permission from Novocure Inc [14]. Copyright 2021 Novocure—all rights reserved.
Figure 2
Figure 2
Optune® Treatment Kit. The system contains an electric field generator to be connected to 2 pair of transducer arrays which are applied directly to the shaved scalp and a battery pack can be carried in a bag. 1. Electric Field Generator (the device), 2. Transducer Arrays, 3. Plug in Power Supply and Power Cords, 4. Portable Batteries and Charger, 5. Connection Cable, 6. Connection Box, 7. Shoulder Bag and Strap, 8. Reproduced with permission from Novocure Inc [14]. Copyright 2021 Novocure—all rights reserved. Permission for global image use was obtained from the patient.
See this image and copyright information in PMC

References

    1. Ostrom Q.T., Patil N., Cioffi G., Waite K., Kruchko C., Barnholtz-Sloan J.S. CBTRUS Statistical Report: Primary brain and other central nervous system tumors diagnosed in the United States in 2013–2017. Neuro Oncol. 2020;22:1–96. doi: 10.1093/neuonc/noaa200. - DOI - PMC - PubMed
    1. Brodbelt A., Greenberg D., Winters T., Williams M., Vernon S., Collins V.P., the National Cancer Information Network Brain Tumour Group Glioblastoma in England: 2007–2011. Eur. J. Cancer. 2015;51:533–542. doi: 10.1016/j.ejca.2014.12.014. - DOI - PubMed
    1. Stupp R., Hegi M.E., Mason W.P., van den Bent M.J., Taphoorn M.J., Janzer R.C., Ludwin S.K., Allgeier A., Fisher B., Belanger K., et al. European Organisation for Research and Treatment of Cancer Brain Tumour and Radiation Oncology Groups; National Cancer Institute of Canada Clinical Trials Group. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol. 2009;10:459–466. - PubMed
    1. Stupp R., Taillibert S., Kanner A., Read W., Steinberg D., Lhermitte B., Toms S., Idbaih A., Ahluwalia M.S., Fink K., et al. Effect of tumor-treating fields plus maintenance temozolomide vs maintenance temozolomide alone on survival in patients with glioblastoma: A randomized clinical trial. JAMA. 2017;318:2306–2316. doi: 10.1001/jama.2017.18718. - DOI - PMC - PubMed
    1. Cohen K.J., Pollack I.F., Zhou T., Buxton A., Holmes E.J., Burger P.C., Brat D.J., Rosenblum M.K., Hamilton R.L., Lavey R.S., et al. Temozolomide in the treatment of high-grade gliomas in children: A report from the Children’s Oncology Group. Neuro Oncol. 2011;13:317–323. doi: 10.1093/neuonc/noq191. - DOI - PMC - PubMed

LinkOut - more resources