TTFields Therapy: Preclinical and Clinical Data

Abstract Tumor Treating Fields (TTFields) is a novel antimitotic cancer treatment modality that works with specialized low-intensity (1–3 V/cm) and intermediate frequency (∼200 kHz) electric fields. For glioblastoma patients, TTFields is delivered noninvasively through two orthogonal pairs of transducer arrays placed on the shaved scalp. Tumor cells are disrupted during mitosis, with the specific frequency tuned for distinct cancer cell lines, while quiescent cells are not affected. This chapter covers a short introduction to the basics of electric fields including a description of the mechanisms of action of TTFields. Preclinical findings are outlined and the clinical application of TTFields discussed. The induced electric field distribution within the cranium is explained and illustrated with computational modeling. The last part of the chapter will comment on neuroimaging in patients treated with TTFields including a discussion of response criteria, pseudoprogression, and other treatment-related changes in patients.