Combining tumor treating fields (TTFields) with standard chemotherapy could be a promising option for the first-line treatment of inoperable malignant pleural mesothelioma, say the STELLAR investigators.
They explain in The Lancet Oncology that TTFields are “a non-invasive, regional, antimitotic treatment for solid tumours, that is based on the delivery of low-intensity alternating electric fields to the tumour,” which has demonstrated “promising preclinical results in mesothelioma models.”
This phase II trial enrolled 80 participants who received continuous TTFields to the thorax for at least 18 hours/day at a frequency of 150 kHz alongside up to six cycles of chemotherapy with pemetrexed plus cisplatin or carboplatin, followed by maintenance TTFields for those who did not progress after chemotherapy.
Participants were followed up for a median of 12.5 months, during which time they achieved a median overall survival (OS) of 18.2 months, with 1- and 2-year rates of 62.2% and 41.9%, respectively.
Median progression-free survival (PFS) was 7.6 months, and the objective response rate as per RECIST criteria was 40% (all partial responses) among the 72 evaluable patients. Just over half (56%) of trial participants went on to receive further treatment after disease progression.
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