Optune in Glioblastoma: Revolutionizing Treatment with Tumor Treating Fields
DOI:
https://doi.org/10.12775/QS.2025.41.60190Keywords
glioblastoma, Tumor Treating Fields, Optune, clinical trials, survival outcomesAbstract
Introduction: Glioblastoma multiforme (GBM) is one of the most aggressive primary brain tumors in adults, known for its rapid progression and poor prognosis. Despite advancements in surgical resection, radiotherapy, and chemotherapy, the median survival for GBM patients remains limited. In recent years, Tumor Treating Fields (TTFields), commercially known as Optune, have emerged as an innovative, non-invasive therapeutic approach. TTFields utilize alternating electric fields to interfere with the mitotic processes of cancer cells, thereby inhibiting tumor growth. This paper aims to provide an in-depth review of the current understanding of TTFields therapy, assess its clinical efficacy, and explore future directions in GBM management.
Materials and methods: A systematic literature review was conducted, focusing on peer-reviewed articles published between 2017 and 2025. The search was performed using databases such as PubMed, JAMA, Lancet Oncology, Neuro-Oncology etc. Keywords included “glioblastoma,” “Tumor Treating Fields,” “Optune,” “clinical trials,” and “survival outcomes”.
Summary: The integration of TTFields therapy into the standard GBM treatment regimen represents a significant advancement in neuro-oncology. Clinical evidence indicates that TTFields, particularly in combination with temozolomide, can extend survival and delay disease progression in GBM patients.
Conclusions: TTFields therapy has emerged as a promising adjunctive treatment for glioblastoma, offering new hope for patients facing this highly aggressive disease. While current data support its efficacy and safety, further large-scale studies are needed to refine treatment protocols, identify predictive biomarkers, and assess long-term benefits. As research advances, TTFields may become an integral part of multimodal glioblastoma therapy, potentially improving both survival rates and quality of life for patients.
References
1. Ostrom QT, Patil N, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan J. CBTRUS statistical report: Primary brain and other central nervous system tumors diagnosed in the United States in 2013–2017. Neuro Oncol.2020;22(Suppl 2):iv1-iv96. doi:10.1093/neuonc/noaa200
2. Miranda-Filho A, Piñeros M, Soerjomataram I, Deltour I, Bray F. Cancers of the brain and CNS: global patterns and trends in incidence. Neuro Oncol. 2017;19(2):270-280. doi:10.1093/neuonc/now166
3. Skaga E, Trewin-Nybråten CB, Niehusmann P, et al. Stable glioma incidence and increased patient survival over the past two decades in Norway: a nationwide registry-based cohort study. Acta Oncol. 2024;63:83-94. doi:10.2340/1651-226X.2024.24970
4. Kanderi T, Munakomi S, Gupta V. Glioblastoma Multiforme. PubMed. Published 2020. https://pubmed.ncbi.nlm.nih.gov/32644380/. Accessed February 27, 2025
5. Stoyanov SG, Dzhenkov D, Ghenev P, Iliev B, Enchev Y, Tonchev AB.
Cell biology of glioblastoma multiforme: from basic science to diagnosis and treatment. Med. Oncol. 2018;35(3):27. doi:10.1007/s12032-018-1083-x
6. Królicki B. Wtórne glejaki wielopostaciowe – różnice dotyczące przebiegu klinicznego oraz aktywności biologicznej. Onkologia po Dyplomie. Published 2018. https://podyplomie.pl/onkologia/29715%2Cwtorne-glejaki-wielopostaciowe-roznice-dotyczace-przebiegu-klinicznego-oraz-aktywnosci. Accessed February 27, 2025
7. Heidari A, Sharif PM, Rezaei N. The Association between Tumor-associated Macrophages and Glioblastoma: A Potential Target for Therapy. Curr Pharm Des. 2021;27(46):4650-4662. doi:10.2174/1381612827666210816114003
8. Schaff LR, Mellinghoff IK. Glioblastoma and Other Primary Malignancies in Adults: A Review. JAMA. 2023;329(7):574-587. doi:10.1001/jama.2023.0023
9. Hu LS, D’Angelo F, Weiskittel TM, et al. Integrated molecular and multiparametric MRI mapping of high-grade glioma identifies regional biologic signatures. Nat Commun. 2023;14(1):6066. doi:10.1038/s41467-023-41559-1
10. Czarnywojtek A, Borowska M, Dyrka K et al. Glioblastoma Multiforme: The Latest Diagnostics and Treatment Techniques. Pharmacology. 2023;108(5):423-431. doi:10.1159/000531319
11. McAleavey PG, Walls GM, Chalmers AJ. Radiotherapy-drug combinations in the treatment of glioblastoma: a brief review. CNS Oncol. 2022;11(2):CNS86. doi:10.2217/cns-2021-0015
12. McBain C, Lawrie TA, Rogozińska E, Kernohan A, Robinson T, Jefferies S. Treatment options for progression or recurrence of glioblastoma: a network meta-analysis. Cochrane Database Syst Rev. 2021;5(1):CD013579. doi:10.1002/14651858.CD013579.pub2
13. Wen PY, Weller M, Lee EQ, et al. Glioblastoma in adults: a Society for Neuro-Oncology (SNO) and European Society of Neuro-Oncology (EANO) consensus review on current management and future directions. Neuro Oncol. 2020;22(8):1073-1113. doi:10.1093/neuonc/noaa106
14. Chen D, Le SB, Hutchinson TE, et al. Tumor Treating Fields dually activate STING and AIM2 inflammasomes to induce adjuvant immunity in glioblastoma. J Clin Invest. 2022;132(8):e149258. doi:10.1172/JCI149258
15. Li X, Liu K, Xing L, Rubinsky B. A review of tumor treating fields (TTFields): advancements in clinical applications and mechanistic insights. Radiol Oncol. 2023;57(3):279-291. doi:10.2478/raon-2023-0044
16. Khagi S, Kotecha R, Gatson NTN, et al. Recent advances in Tumor Treating Fields (TTFields) therapy for glioblastoma. Oncologist. 2024:oyae227. doi:10.1093/oncolo/oyae227.
17. Salvador E, Köppl T, Hörmann J, et al. Tumor Treating Fields (TTFields) Induce Cell Junction Alterations in a Human 3D In Vitro Model Of The Blood-Brain Barrier. Pharmaceutics. 2023;15(1):185. doi:10.3390/pharmaceutics15010185
18. Salvador E, Kessler AF, Domröse D, et al. Tumor Treating Fields (TTFields) Reversibly Permeabilize the Blood-Brain Barrier In Vitro and In Vivo. Biomolecules. 2022;12(10):1348. doi:10.3390/biom12101348
19. Chang E, Patel CB, Pohling C, et al. Tumor treating fields increases membrane permeability in glioblastoma cells. Cell Death Discov. 2018;4(1):113. doi:10.1038/s41420-018-0130-x
20. Karanam NK, Srinivasan K, Ding L, et al. Tumor treating fields elicit a conditional vulnerability to ionizing radation via the downregulation of BRCA1 signaling and reduced DNA double-strand break repair capacity in non-small cell lung cancer cell lines. Cell Death Dis. 2017;8(3):e2711. doi:10.1038/cddis.2017.136
21. Karanam NK, Ding L, Aroumougame A, Story MD. Tumor treating fields cause replication stress and interfere with DNA replication fork maintenance: Implications for cancer therapy. Transl Res. 2020;217:33-46. doi:10.1016/j.trsl.2019.10.003
22. Voloshin T, Schneiderman RS, Volodin A, et al. Tumor Treating Fields (TTFields) hinder cancer cell motility through regulation of microtubule and actin dynamics. Cancers (Basel). 2020;12(10):3016. doi:10.3390/cancers12103016
23. Stupp R, Taillibert S, Kanner A, 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(23):2306-2316. doi:10.1001/jama.2017.18718
24. Novocure. Novocure’s Optune (NovoTTF-110A) approved in Japan for the treatment of newly diagnosed glioblastoma. Novocure. Published March 12, 2024. https://www.novocure.com/novocures-optune-novottf-100a-approved-in-japan-for-the-treatment-of-newly-diagnosed-glioblastoma/. Accessed February 27, 2025
25. ZaiLab. China NMPA approves Optune for the treatment of newly diagnosed and recurrent glioblastoma. GlobeNewswire. Published May 13, 2020. https://www.globenewswire.com/news-release/2020/05/13/2032766/0/en/China-NMPA-Approves-Optune-for-the-Treatment-of-Newly-Diagnosed-and-Recurrent-Glioblastoma.html. Accessed February 27, 2025
26. Fisher JP, Adamson DC. Current FDA-approved therapies for high-grade malignant gliomas. Biomedicines. 2021;9(3):324. doi:10.3390/biomedicines9030324
27. Novocure. Novocure announces Japanese approval of Optune (the NovoTTF-100A System) for treatment of recurrent glioblastoma. https://www.novocure.com/novocure-announces-japanese-approval-of-optune-the-novottf-100a-system-for-treatment-of-recurrent-glioblastoma/. Accessed February 27, 2025
28. American Association of Neurological Surgeons. Glioblastoma multiforme. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Glioblastoma-Multiforme. Accessed February 27,2025
29. Health Canada. Health Canada approves Novocure’s Optune to treat glioblastoma. https://www.medicaldevice-network.com/news/health-canada-novocure-optune/. Accessed February 27, 2025
30. U.S. Food and Drug Administration (FDA). Premarket Approval (PMA): Optune. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100034S013. Accessed February 27, 2025
31. Novocure. Novocure announces CE mark and first patient of second generation Optune system. https://www.novocure.com/novocure-announces-ce-mark-and-first-patient-use-of-second-generation-optune-system/. Accessed February 27, 2025
32. Novocure. Novocure converts more than 500 U.S. patients to second generation Optune within four weeks of FDA approval on July 13. https://www.novocure.com/novocure-converts-more-than-500-u-s-patients-to-second-generation-optune-within-four-weeks-of-fda-approval-on-july-13/. Accessed February 27, 2025
33. Kesari S, Ram Z. EF-14 Trial Investigators. Tumor-Treating Fields plus chemotherapy versus chemotherapy alone for glioblastoma at first recurrence: a post hoc analysis of the EF-14 trial. CNS Oncol. 2017;6(3):185-193. doi:10.2217/cns-2016-0049
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Patrycja Długozima, Klaudia Mączewska, Dominika Hakało, Julia Kozakiewicz , Kamil Kościelecki , Agnieszka Kalisz , Iwona Skorulska , Paulina Grzeszczuk , Weronika Grywińska , Aleksandra Głowacka

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 36
Number of citations: 0