January 28, 2020 by Ana Belzarena Genovese M.D.
Miami Cancer Institute Pioneers ‘Tumor Treating Fields’ to Fight Deadly Cancers
Miami Cancer Institute has begun implementing an innovative, cancer-fighting wearable device known as Tumor Treating Fields, or TTFields, for patients with malignant pleural mesothelioma. The Institute is just one of three centers nationwide to receive approval to administer the treatment.
Malignant pleural mesothelioma (MPM) is a rare but aggressive form of cancer that involves the membrane covering the lungs. It is most commonly a result of inhaling asbestos. It is the first new treatment approved for mesothelioma by the U.S. Food and Drug Administration (FDA) in more than 15 years and it is administered in combination with chemotherapy.
The noninvasive TTFields device disrupts cancer cell division through low-voltage electric fields. TTField therapy uses small transducers that are attached to the torso, in the case of mesothelioma patients, with adhesive bandages. The transducers are connected to wires, which are plugged into a battery. The batteries fit into a bag that the person carries with them. The patient takes the device home and wears it for at least 18 hours a day.
(Watch now: The Baptist Health News Team hears from Rupesh Kotecha, M.D., radiation oncologist at Miami Cancer Institute about the innovative new device that targets tumor cells in certain patients with rare and aggressive cancers. Video by George Carvalho.)
“TTF fields actually provide alternating electrical energy that’s guided or targeted to the area in the lungs where the disease exists,” said Rupesh Kotecha, M.D., radiation oncologist at Miami Cancer Institute. “They’re placed on the patient in a very specific position those positions may differ between patients based on the location of the disease, or even based on the anatomy of the patient.”
The Miami Cancer Institute has joined the West Cancer Center in Memphis, Tennessee, and the Oregon Health & Sciences University as the first three centers to receive approval for its use with pleural mesothelioma.
The FDA first approved the use of TTFields in 2015 for glioblastoma, an aggressive form of brain cancer. The treatment is also being studied to target other diseases, including lung, pancreatic and ovarian cancers. Dr. Kotecha has experience using TTFields at the Miami Cancer Institute to treat glioblastoma.
The first patient recently treated with TTFields for malignant pleural mesothelioma is an 80-year-old male.
“Our first patient is a retired gentleman who is still very active and wanted to maintain his activity for as long as he can, given that chemotherapy is only given for a certain number of cycles,” explains Dr. Kotecha. “He was looking for a treatment that could potentially provide some more durability in disease control.”
Before a cancer cell replicates itself, its proteins form chains that pull apart the copies of genetic matter in the cell’s nucleus. The TTFields device works to disrupt this process.
The FDA approval for treating mesothelioma patients with TTFields followed a clinical trial across Europe referred to as STELLAR. The TTFields device, officially called the NovoTTF-100L System, was developed by Novocure, a global company based in the United Kingdom.
The study’s results included one- and two-year survival rates of 62.2 percent and 41.9 percent, respectively. The median overall survival of the 80 patients in the trial was 18.2 months. Overall, the one-year survival rate for pleural mesothelioma is about 40 percent.
“We’re able to see patients from all over the country for this type of treatment,” says Dr. Kotecha. “TTF treatments will be available at very few centers, including Miami Cancer Institute. We specialize in taking care of patients who have very complicated diagnoses or even very rare diagnoses.”