Tumour treating fields in a combinational therapeutic approach
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Joshua Branter1, Surajit Basu2 and Stuart Smith1
1Children’s Brain Tumour Research Centre, School of Medicine, University of Nottingham, Queen’s Medical Centre, Nottingham, UK
2Queen’s Medical Centre, Department of Neurosurgery, Nottingham, UK
Joshua Branter, email: [email protected]
Keywords: tumour treating fields; TTFields; combination therapy; optune, glioblastoma
Received: December 14, 2017 Accepted: October 24, 2018 Published: November 27, 2018
The standard of care for patients with newly diagnosed Glioblastoma multiforme (GBM) has remained unchanged since 2005, with patients undergoing maximal surgical resection, followed by radiotherapy plus concomitant and maintenance Temozolomide. More recently, Tumour treating fields (TTFields) therapy has become FDA approved for adult recurrent and adult newly-diagnosed GBM following the EF-11 and EF-14 trials, respectively. TTFields is a non-invasive anticancer treatment which utilizes medium frequency alternating electric fields to target actively dividing cancerous cells. TTFields selectively targets cells within mitosis through interacting with key mitotic proteins to cause mitotic arrest and cell death. TTFields therapy presents itself as a candidate for the combinational therapy route due to the lack of overlapping toxicities associated with electric fields. Here we review current literature pertaining to TTFields in combination with alkylating agents, radiation, anti-angiogenics, mitotic inhibitors, immunotherapies, and also with novel agents. This review highlights the observed synergistic and additive effects of combining TTFields with various other therapies, as well highlighting the strategies relating to combinations with electric fields.
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