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Tumor Treating Fields (TTFields) for Mesothelioma

Tumor treating fields (TTFields or TTF) is a novel, non-invasive treatment that uses mild electrical fields to disrupt the growth of cancer cells. It is a relatively new treatment for pleural mesothelioma that was approved by the U.S. Food and Drug Administration (FDA) in 2019. Learn how Mesothelioma Hope can help you find doctors experienced with TTFields, chemotherapy, and other proven treatment methods.

Fact-Checked and Updated by: Jenna Tozzi, RN

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What Is Tumor Treating Fields (TTF)?

Tumor Treating Fields is a type of cancer treatment that involves the use of alternating electrical fields to keep tumor cells from dividing and multiplying. The electrical waves are sent safely through the skin through adhesive patches called arrays that can be applied directly to the area where the cancer is located.

This therapy received FDA approval in 2011 to help treat glioblastoma, a type of brain cancer, before being approved for the treatment of pleural mesothelioma in 2019.

TTF is administered together with chemotherapy to enhance the activity of proteins that can destroy cancer DNA. By targeting cancer cells at a molecular level, this combination therapy has been proven to increase survival rates for patients with mesothelioma.

How Tumor Treating Fields Is Used to Treat Mesothelioma

In this type of mesothelioma treatment, patients wear a portable device called the Optune Lua® that sends low-intensity TTFields to the area of the body where their tumor is located.

Created by global oncology company Novocure, the Optune Lua is designed for continuous use, allowing mesothelioma patients to carry on with their day-to-day activities while receiving treatment.

If you have been diagnosed with pleural mesothelioma, use our Free Doctor Match to find a specialist who’s experienced with TTFields and other emerging therapies.

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Who Can Get Tumor Treatment Fields?

Mesothelioma patients with unresectable malignant pleural mesothelioma may be eligible for TTFields. Metastatic mesothelioma is late-stage cancer that has spread to distant lymph nodes and other parts of the body. Unresectable means that the tumors cannot be removed using surgery.

Patients with the epithelioid mesothelioma cell type may especially benefit from TTFields. Epithelioid mesothelioma cells are the most common mesothelioma cell type.

Epithelioid mesothelioma grows slower than sarcomatoid and biphasic (mixed) mesothelioma, making it easier to attack with TTFields, chemotherapy, and other treatment methods.

Patients with the following characteristics may not be eligible to receive TTFields:

  • Potential or active pregnancy
  • Sensitivity to conductive gel
  • Implanted electronic devices (pacemaker or automatic defibrillator)

A mesothelioma specialist can determine if you qualify for treatment with TTFields. Contact Mesothelioma Hope now to be connected with doctors at top mesothelioma cancer centers across the country.

Can TTFields Increase Survival Time?

Yes, research suggests that TTFields can increase the survival rates of pleural mesothelioma patients. Survival rate is the percent of people still alive after a set amount of time.

According to a 2022 clinical trial known as the STELLAR study, the 1-year survival rate of patients treated with TTFields and chemotherapy was 62%, and the 2-year survival rate was 42%.

Further, the STELLAR trial showed that patients who received TTFields through the NovoTTF™-100L System had a median overall survival of 18.2 months. In comparison, the median survival for mesothelioma patients without treatment is 4-12 months, as reported in Cancer Therapy Advisor.

Read about patients who are living longer with treatment in our Free Survivors Guide — packed with 70+ pages of hope to help you and your loved ones.

How TTF Targets Mesothelioma Tumors

TTFields treatment targets mesothelioma tumors by attacking them with electrical fields, disrupting proteins, stopping cancer cell growth, and encouraging tumor cell death.

Attacking Tumors With Electrical Fields

TTFields delivers electricity through insulated pads that stick to your skin. The Optune Lua device uses a frequency of 100 to 300 kilohertz (kHz) and delivers the electricity at an intensity of 1 to 3 volts per centimeter.

A 2021 study published in the journal Lung Cancer found that TTFields delivered at a frequency of 150 kHz have the highest cytotoxicity (cell-killing ability) for malignant pleural mesothelioma (MPM).

Disrupting Proteins

Cancer cells grow due to the influence of certain proteins, such as spindle and tubulin. These proteins prompt cancer cells to duplicate the important parts of a mesothelioma tumor cell and split them between two new cancer cells.

The patches that deliver the electrical TTFields can disrupt these proteins when applied to your skin.

The results of a clinical study in a 2020 edition of the journal Cancers indicate that TTFields can more effectively prevent glioblastoma cancer cells from migrating when the currents are applied perpendicularly to the movement of the cells.

Stopping Cancer Cell Growth

After disrupting these proteins, cancer cells may stop growing and spreading. Multiple studies — including a 2022 Cell Death Discovery report — noted that TTFields treatment damages cells as they are dividing and causes them to die, which can slow down their overall spread.

Encouraging Tumor Cell Death

TTFields may also kill certain cancer cells. Studies have shown that electrical forces on proteins interfered with chromosome separation during mitosis (cell division) and caused apoptosis (cell death).

What Can I Expect With Tumor Treating Fields?

If you are eligible for TTFields, here’s a brief overview of how the process usually goes.

1. Receive Your TTFields Device

The first step is to receive your Optune Lua. The Optune Lua comes with a portable TTFields-generating device, rechargeable batteries, a battery charger, insulated pads, a power supply, and a backpack.

The Optune mesothelioma device is unique since it allows patients to receive treatment while doing their normal activities.

2. Have the Device Pads Applied to Your Chest

After receiving the Optune Tumor Treating Fields device, you can apply it yourself at home with the help of a caregiver or have it applied in the hospital by a health care provider.

If you choose to apply the TTFields at home, you will receive training from a Novocure® Support Specialist on how and where to place the patches on your upper body.

3. Continue With Your Daily Activities

The Optune Lua device is designed for continual use on the go, at the hospital, or at home. You can work, watch videos, do chores, and perform other daily activities while receiving TTFields therapy.

Did You Know?

Most cancer care teams advise patients to wear the Optune Lua for 18 to 20 hours a day.

However, you must keep the device charged as you continue with daily activities. You can power the Optune Lua by using a large rechargeable battery pack or plugging it into a power supply.

4. Combine Optune TTF With Chemotherapy

You will receive platinum-based chemotherapy with carboplatin or cisplatin in addition to pemetrexed (Alimta®) every three weeks for six cycles. Studies have shown that using the Optune Lua does not increase the toxicity of chemotherapy medications.

5. Monitor Progress and Make Adjustments

You will attend regular follow-up appointments to monitor the progress of your treatment. Based on these evaluations, your doctor may adjust your treatment plan or add other therapies.

You can learn more about the process and see if you’re a candidate for TTFields by speaking with a mesothelioma specialist. Use our Free Doctor Match tool to find doctors who specialize in pleural mesothelioma.

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Benefits of TTFields for Mesothelioma

As an emerging treatment for mesothelioma, TTFields offers many benefits when used in combination with chemotherapy and other conventional cancer treatments.

Here some of the key benefits of TTFields for mesothelioma:

  • Convenience. You can receive TTFields therapy on the go, at home, or in the hospital. The only exception is when you’re getting chemotherapy for TTFields, which must be administered at your chosen cancer center.
  • Minimal discomfort. Since TTFields is not an invasive treatment, it normally causes patients little discomfort or pain.
  • Reduced travel expenses. Because you can receive TTFields while you’re at home, you may be able to lower your out-of-pocket travel costs.

Potential Side Effects and Adverse Events

Though TTFields therapy has shown promising results, it is not without side effects or potential adverse events.

Some patients in clinical trials have reported anemia and other blood disorders. However, these side effects were much more manageable and less severe compared to the typical toxicity of other treatments like chemotherapy.

Common Side Effects

Compared to conventional treatments like chemotherapy and radiation, TTFields therapy usually has milder and less severe side effects. While chemotherapy and radiation can cause nausea, vomiting, fatigue, and a higher risk of infection, the main side effect of TTFields therapy is skin irritation, which is typically limited to the area where the tumor treatment fields are attached.

If a patient experiences irritation at the sites where TTFields are applied, it can usually be managed with topical creams or by changing the placement of the patches.

Potential Risks and Complications

While TTFields therapy is generally safe, potential risks and complications can occur if not administered correctly. For example, improper use can lead to skin burns.

Also, it’s important not to use other medical devices or heating pads over the patches since they may interfere with the TTFields or cause burns. Patients with implanted electronic devices like pacemakers or defibrillators should ask their mesothelioma doctor before starting TTFields therapy.

Cost of Tumor Treating Fields for Mesothelioma

The cost of using TTFields for mesothelioma varies depending on your insurance coverage and the details of your treatment plan. Plans that have longer chemotherapy cycles tend to be more expensive than those with shorter ones.

If you are worried about the cost of tumor treatment fields, talk to a Mesothelioma Hope advocate today. We can help determine if you may be owed mesothelioma compensation from negligent manufacturers who exposed you or a loved one to harmful asbestos-containing products.

By filing a claim, you can pursue compensation for medical costs, pain and suffering, and other damages associated with your mesothelioma diagnosis. Contact us now at (866) 608-8933 to see if you qualify for financial assistance.

Where Can I Get TTFields for Mesothelioma?

Mesothelioma patients can receive TTFields at certified Optune Lua cancer centers and hospitals across the country.

The following mesothelioma treatment centers offer TTFields:

Once you’ve found a treatment center, you will typically consult a TTFields-trained health care professional to see if you are a good candidate for this treatment. They will review your medical history and discuss the benefits and potential side effects.

Find top specialists and cancer centers right now by enrolling in our Free Doctor Match program.

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We'll help you connect with a local mesothelioma specialist for personalized treatment.

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Find Tumor Treating Fields Therapy for Mesothelioma

Finding the best TTF therapy for mesothelioma can be daunting for pleural mesothelioma patients and their caregivers. It can also be costly if your insurance doesn’t cover TTF.

Our Patient Advocates can provide your family with free resources about doctors, clinical trials, and how to pay for TTFields and other treatments.

Call (866) 608-8933 today or use our Free Doctor Match to learn more about your options and find a specialist for treatment.

Mesothelioma Tumor Treating Fields FAQs

What is a tumor treatment field for mesothelioma?

A tumor treating field (TTField) for mesothelioma is a treatment method that uses a portable device to deliver electricity to mesothelioma tumors. TTFields is used with standard of care chemotherapy to prevent cancer from growing and spreading.

Do tumor treatment fields work?

Yes, tumor treatment fields work and can help many mesothelioma patients live longer. This treatment can slow disease progression, extend your life expectancy, and improve your overall quality of life when prescribed with chemotherapy.

However, TTFields cannot cure mesothelioma since it is a fatal condition.

How much does Tumor Treating Fields cost?

The cost of TTFields largely depends on your insurance plan, according to Optune Lua manufacturer Novocure. However, not every insurance plan covers cancer treatments like tumor treating fields therapy.

If your plan doesn’t cover TTFields for treatment of malignant pleural mesothelioma, you may be eligible to file a mesothelioma lawsuit against the companies responsible for your asbestos exposure.

Talk to a Mesothelioma Hope Patient Advocate at (866) 608-8933 to learn more about getting financial assistance for your treatment.

Jenna TozziWritten by:

Director of Patient Advocacy

Jenna Tozzi, RN, is the Director of Patient Advocacy at Mesothelioma Hope. With more than 15 years of experience as an adult and pediatric oncology nurse navigator, Jenna provides exceptional guidance and support to mesothelioma patients and their loved ones. Jenna has been featured in Oncology Nursing News and is a member of the Academy of Oncology Nurse & Patient Navigators & the American Nurses Association.

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References
  1. IASLC Lung Cancer News (2020). TTFields in Mesothelioma (The STELLAR Trial): More Stars Needed in the Constellation. Retrieved February 20, 2024, from https://www.ilcn.org/ttfields-in-mesothelioma-the-stellar-trial-more-stars-needed-in-the-constellation/
  2. Kheir, F. (2017). Pleural plaques/Mesothelioma. Retrieved February 20, 2024, from https://www.cancertherapyadvisor.com/home/decision-support-in-medicine/hospital-medicine/pleural-plaques-mesothelioma/
  3. Kutuk, T., et al. (2022). Feasibility of Tumor Treating Fields with Pemetrexed and Platinum-Based Chemotherapy for Unresectable Malignant Pleural Mesothelioma: Single-Center, Real-World Data. Cancers, 14(8), 2020. Retrieved February 20, 2024, from https://doi.org/10.3390/cancers14082020
  4. Mannarino, L., et al. (2022). Tumor treating fields affect mesothelioma cell proliferation by exerting histotype-dependent cell cycle checkpoint activations and transcriptional modulations. Cell Death & Disease, 13(612). Retrieved February 20, 2024, from https://doi.org/10.1038/s41419-022-05073-4
  5. Mumblat, H., et al. (2021). Tumor Treating Fields (TTFields) downregulate the Fanconi Anemia-BRCA pathway and increase the efficacy of chemotherapy in malignant pleural mesothelioma preclinical models. Lung cancer (Amsterdam, Netherlands), 160, 99–110. Retrieved February 20, 2024, from https://doi.org/10.1016/j.lungcan.2021.08.011
  6. Tanzhu, G., et al. (2022). The schemes, mechanisms and molecular pathway changes of Tumor Treating Fields (TTFields) alone or in combination with radiotherapy and chemotherapy. Cell Death Discov. 8, 416. Retrieved February 20, 2024, from https://doi.org/10.1038/s41420-022-01206-y
  7. U.S. Securities and Exchange Commission. (2019). FDA Approves the NovoTTF-100L System in Combination with Chemotherapy for the Treatment of Malignant Pleural Mesothelioma. Retrieved February 20, 2024, from https://www.sec.gov/Archives/edgar/data/1645113/000156459019020381/nvcr-ex991_14.htm
  8. Wenger, C., et al. (2018). A Review on Tumor-Treating Fields (TTFields): Clinical Implications Inferred From Computational Modeling. IEEE reviews in biomedical engineering, 11, 195–207. Retrieved February 20, 2024, from https://doi.org/10.1109/RBME.2017.2765282
  9. Zhang, C., et al. (2020). The Value of Tumor Treating Fields in Glioblastoma. Journal of Korean Neurosurgical Society, 63(6), 681–688. Retrieved February 20, 2024, from https://doi.org/10.3340/jkns.2019.0224
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