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. 2025 May;173(1):49-57.
doi: 10.1007/s11060-025-04946-w. Epub 2025 Mar 31.

Long-term survival, patterns of progression, and patterns of use for patients with newly diagnosed glioblastoma treated with or without Tumor Treating Fields (TTFields) in a real-world setting

Devon C Riegel  1 , Britta L Bureau  2 , Patrick Conlon  3 , Gordon Chavez  3 , Jennifer M Connelly  2
Affiliations

Long-term survival, patterns of progression, and patterns of use for patients with newly diagnosed glioblastoma treated with or without Tumor Treating Fields (TTFields) in a real-world setting

Devon C Riegel et al. J Neurooncol. 2025 May.

Abstract

Purpose: Tumor Treating Fields therapy (TTFields) is an FDA-approved locoregional treatment for patients with newly diagnosed glioblastoma (ndGBM). Previous trial data showed the addition of TTFields to standard TMZ-based therapy to significantly improve overall survival (OS), but real-world data is lacking, particularly with long follow-up duration. Here, we report real-world survival, patterns of progression, and patterns of use for patients for patients with ndGBM treated with or without TTFields.

Methods: Patients diagnosed with GBM and treated with standard of care therapy at the Medical College of Wisconsin between March 2015-March 2023 were included. Survival outcomes were assessed and compared across groups who received or did not receive TTFields therapy during maintenance treatment. Patients were followed through March 1, 2024.

Results: A total of 208 patients (TTFields: n = 109; No-TTFields: n = 99) were included for analysis. Baseline characteristics were consistent across groups. Median OS and PFS were significantly improved for the TTFields group vs. No-TTFields group (median OS: 21.7 vs. 17.7 months, p = 0.029; median PFS: 12.4 vs. 9.6 months, p = 0.047). Patients treated with TTFields exhibited a higher rate of non-local progression vs. No-TTFields group. Median OS and PFS were each significantly longer for the ≥ 75% usage group compared with < 75% via matched analysis.

Conclusion: The results of this study reveal an association between TTFields use and long-term survival benefit, consistent with pivotal trial findings. TTFields use is associated with a higher incidence of non-local patterns of progression, and TTFields device usage ≥ 75% is associated with increased progression-free and long-term survival.

Keywords: Glioblastoma; Progression; Tumor Treating Fields; Usage.

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Conflict of interest statement

Declarations. Ethical approval: This study was performed in line with the principles of the Declaration of Helsinki. Institutional Review Board (IRB) approval was granted by the Ethics Committee of the Medical College of Wisconsin (11/11/2019, PRO00036224). Consent to participate and publish: Participant consent was waived per IRB. De-identified data was used for analysis and all participants remain de-identified in the body of the manuscript and figures. Competing interests: Authors Patrick Conlon and Gordon Chavez are current employees of Novocure Inc. Jennifer M. Connelly recently served on a Physician Advisory Panel for Novocure. Devon C. Riegel, and Britta L. Bureau declare they have no financial interests.

Figures

Fig. 1
Fig. 1
Overall (A) and progression-free survival (B) for patients by TTFields therapy cohort
Fig. 2
Fig. 2
Spatial pattern of progression for patients by TTFields therapy cohort. Rate of non-local progression overall (A) and by anatomic location (B), with example patterns shown for TTFields-treated cohort (C)
Fig. 3
Fig. 3
Patterns of TTFields device usage and correlation with overall survival. Device usage rate overall (A) and by length of TTFields therapy use (B). Overall survival for IDH-wt patients by usage level from unmatched (C) and propensity-score matched (D) cohort analysis
See this image and copyright information in PMC

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