Miami Cancer Institute Finds Success with TTFields for Mesothelioma
Treatment & DoctorsWritten by Dr. Rupesh Kotecha | Edited By Walter Pacheco
Before 2019, the only U.S. Food and Drug Administration-approved treatment for unresectable, locally advanced or metastatic mesothelioma was a single chemotherapy option. The mesothelioma chemotherapy mixture of pemetrexed (Alimta) with cisplatin or carboplatin had been the therapeutic standard since 2004.
At Miami Cancer Institute, part of Baptist Health South Florida, when we first heard of the potential of Tumor Treating Fields for mesothelioma patients I knew our team could make it a reality.
Tumor Treating Fields Slows Mesothelioma Growth
Mesothelioma affects about 3,000 people per year. In 2019, the FDA approved TTFields for mesothelioma as a Humanitarian Use Device, meaning it could potentially benefit people with this rare disease.
Since then we’ve created an Institutional Review Board-approved Humanitarian Device Exemption protocol at Miami Cancer Institute to treat patients with the device, and have done so for close to three years.
TTFields uses alternating low-intensity, intermediate-frequency electric fields tuned to disrupt cancer cell growth. Patients apply adhesive transducer arrays to their skin that deliver the therapy throughout the day. Scientists have used these energy fields to successfully limit the development and progression of glioblastoma, an aggressive brain cancer, and improve patient survival.
Patients with locally advanced or metastatic disease who are not eligible for mesothelioma surgery are candidates for TTFields. We’ve found that about two-thirds of our mesothelioma patients qualify for the device.
Importantly, patients who receive TTFields therapy must also receive simultaneous chemotherapy for mesothelioma. Because mesothelioma is a locally aggressive disease, many patients don’t have the option of radiation or surgery. TTFields with chemotherapy offers an additional way to control the disease.
Patients Using TTFields Receive Frequent Support
We’ve continued treating patients with TTFields during the COVID-19 pandemic, including those from other states. Patients interested in the device should come to see us for a consultation.
The TTFields program provides patient support 24 hours a day, seven days a week. We want patients to feel like they always have support and answers if needed.
During a patient’s first visit we discuss TTFields treatment and have a practice model in the clinic to demonstrate to patients and their family members how the device works.
On the return visit we submit CT imaging, which helps us design TTFields placement specific to each patient’s cancer. Then, we perform a fitting and have on-site representatives from the device manufacturer to educate on using the therapy at home. This process takes about two hours.
A device support specialist will visit the patient’s home several times a month while the patient is on TTFields to check on any issues such as skin irritation. They will refill supplies such as adhesive pads and diagnose any mechanical problems with the device.
Promising Results for Fall International Presentation
With the data we’ve gathered over the past two to three years of treating mesothelioma patients with TTFields, we’re confident enough to present our results to the larger medical community.
Data across other disease sites and from other studies have been encouraging. We haven’t encountered high-grade toxicities and patient outcomes are improving.
I’ve personally reached out to several other providers and institutions prescribing TTFields, and the results are promising. By presenting our collected data at an international meeting, we’ll have the chance to bring awareness to a new and effective treatment option for mesothelioma patients.
Following the international meeting this fall, our plans with the device include finding new ways to combine other therapies, such as mesothelioma immunotherapy or proton therapy, with TTFields.
At Miami Cancer Institute, we can offer patients a comprehensive approach with specialists who have experience treating this rare disease. With enough real-world evidence of how this treatment can benefit mesothelioma patients, we can better manage toxicities and improve the device’s technology.
Mesothelioma patients who are motivated to find a new treatment option and believe they would be compliant with a medical device are perfect candidates to try out TTFields.