Current status of the preclinical evaluation of alternating electric fields as a form of cancer therapy

Christoph Pohling; Ha Nguyen; Edwin Chang; Keith E Schubert; Ying Nie; Vladimir Bashkirov; Vicky Yamamoto; Yuping Zeng; Roger Stupp; Reinhard W Schulte; Chirag B Patel

doi:10.1016/j.bioelechem.2022.108287

Current status of the preclinical evaluation of alternating electric fields as a form of cancer therapy

Bioelectrochemistry. 2023 Feb:149:108287. doi: 10.1016/j.bioelechem.2022.108287. Epub 2022 Oct 7.

Authors

Affiliations

¹ Division of Biomedical Engineering Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA.
² Department of Electrical and Computer Engineering, Baylor University, Waco, TX 76798, USA.
³ Molecular Imaging Program at Stanford, Department of Radiology, Stanford University School of Medicine, Stanford, CA 94305, USA.
⁴ Department of Neurosurgery, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA.
⁵ Norris Comprehensive Cancer Center, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA.
⁶ Department of Electrical and Computer Engineering, University of Delaware, Newark, DE 19716, USA.
⁷ Department of Neurosurgery; Department of Neurology Division of Neuro-Oncology; Department of Medicine Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
⁸ Division of Biomedical Engineering Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA. Electronic address: rschulte@llu.edu.
⁹ Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX 77030, USA; Cancer Biology Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX 77030, USA. Electronic address: cbpatel@mdanderson.org.

PMID: 36306728
DOI: 10.1016/j.bioelechem.2022.108287

Abstract

Exposing cancer cells to alternating electric fields of 100-300 kHz frequency and 1-4 V/cm strength has been shown to significantly reduce cancer growth in cell culture and in human patients. This form of anti-cancer therapy is more commonly referred to as tumor treating fields (TTFields), a novel treatment modality that has been approved by the U.S. Food and Drug Administration for use in patients with glioblastoma and malignant pleural mesothelioma. Pivotal trials in other solid organ cancer trials are underway. In regards to overall survival, TTFields alone is comparable to chemotherapy alone in recurrent glioblastoma. However, when combined with adjuvant chemotherapy, TTFields prolong median survival by 4.9 months in newly-diagnosed glioblastoma. TTFields hold promise as a therapeutic approach to numerous solid organ cancers. This review summarizes the current status of TTFields research at the preclinical level, highlighting recent aspects of a relatively complex working hypothesis. In addition, we point out the gaps between limited preclinical in vivo studies and the available clinical data. To date, no customized system for TTFields delivery in rodent models of glioblastoma has been presented. We aim to motivate the expansion of TTFields preclinical research and facilitate the availability of suitable hardware, to ultimately improve outcomes in patients with cancer.

Keywords: Alternating electric fields; Biomedical engineering; Cancer; Preclinical; TTFields; Tumor treating fields.

Publication types

Review

MeSH terms

Brain Neoplasms*
Combined Modality Therapy
Electric Stimulation Therapy*
Electricity
Glioblastoma* / therapy
Humans