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Are there particular subgroups of patients with glioblastoma who derive the most benefit from TTFields?
Answer from: Radiation Oncologist at Academic Institution
No validated subgroup has been identified. Patients with MGMT methylated tumors appear to gain most from treatment, but the EF-14 study was not powered to answer that question and patients with unmethylated tumors still saw a benefit. I recommend TTfiel...
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Answer from: Radiation Oncologist at Academic Institution
The subgroup analysis of the EF-14 trial did not specifically and categorically answer this question in the negative, implying that most patients who would have been trial eligible should be offered this option. In practice, we assess the ability of the patient to remain complia...
Answer from: Radiation Oncologist at Academic Institution
EF-14 included patients who had undergone maximal safe surgery when feasible or biopsy and completed standard six weeks of radiotherapy and concomitant temozolomide. Patients who had implanted carmustine wafers were allowed in the study. Patients could only have disease in the supratentori...
Answer from: Radiation Oncologist at Academic Institution
Dr. Stupp et al (JAMA 2017), reported on the outcomes of the randomized phase III trial. A post hoc analysis of the randomized trial, showed that all clinical and molecular subgroups, including patients older than age 65 years as well as patients with MGMT unmethylated tumors benefited, albeit ...
Answer from: Radiation Oncologist at Academic Institution
Because wearing the device most of the day requires considerable inconvenience, commitment, and occasional discomfort, I find it difficult to give a strong recommendation based on the published Phase III EF-14 trial. Since the trial did not include a sham treatment arm, the component of the survival...