Researcher Hopes to Improve Tumor Treating Fields for Mesothelioma

Research & Clinical Trials

Dr. Maurizio D’Incalci already has seen Tumor Treating Fields working for patients with malignant pleural mesothelioma, and applauded the U.S. Food and Drug Administration’s approval of the treatment in 2019.

He also knows the therapy is only scratching the surface of its vast potential and could be even more effective. He wants to help improve it.

D’Incalci, a heralded biomedical science professor at Humanitas University in Milan, Italy, has begun a study exploring various drug combinations that could have a positive, synergistic effect with Tumor Treating Fields for mesothelioma.

“There may be a way to use this tool more effectively,” D’Incalci told The Mesothelioma Center at “We hope to deliver that eventually to patients in the clinic.”

Finding the Right Treatment Synergy

Tumor Treating Fields, also known as TTFields, is a novel therapy designed to disrupt cancer cell division through electrical fields tuned to specific frequencies. It is delivered through insulated adhesive pads attached to the skin.

Research has shown that applying this range of alternating frequencies can disrupt certain proteins essential to cell division. It has proven to slow or stop cancer growth, and is currently used in combination with chemotherapy.

In the phase III clinical trial that led to FDA approval, patients receiving TTFields and chemotherapy survived six months longer than those receiving only chemotherapy, which is the standard of care for the majority of patients. More than 97% of the patients showed at least a partial response.

Median survival climbed from 12.1 months to 18.2 months with TTFields. D’Incalci wants to make that difference grow even more.

“The goal with this study is to get more insight into what works best for patients,” he said. “Mesothelioma is a real challenge. This one modality [TTFields] isn’t enough by itself. But the right combination could make it better.”

Six TTFields Research Grants Awarded

The third annual AACR-Novocure Grants for Tumor Treating Fields Research program was announced early in July. It is a collaboration between the American Association for Cancer Research and Novocure, the global oncology company headquartered in New Jersey that created the treatment.

D’Incalci is one of six medical researchers worldwide who received a grant, ranging from $100,000 to $250,000, to try to make the modality more effective. He is the only one using it specifically with pleural mesothelioma cancer.

The other five grant recipients are:

  • Dr. Claudio E. Tatsui, University of Texas MD Anderson Cancer Center, studying spinal metastases.
  • Dr. Suhe Wang, University of Michigan, non-small cell lung cancer.
  • Sara G.M. Piccirillo, University of New Mexico, glioblastoma.
  • Chang-Young Jang, Sookmyung Women’s University in South Korea, identifying TTFields mitosis targets.
  • Spencer Collis, University of Sheffield in the United Kingdom, exploring combinations to overcome spatiofunctional heterogeneity.

“These grants are so important, especially for these rare diseases like mesothelioma,” D’Incalci said. “That’s how advancements are made.”

Combining TTFields with Keytruda

There is currently one Tumor Treating Fields study in progress involving pembrolizumab, known by the brand name Keytruda, to treat certain types of lung cancer.

Clinical and preclinical research over the past two decades has allowed Novocure to execute its therapeutic strategy. The first FDA approval for the treatment involved glioblastoma, a type of brain cancer, in 2011.

Studies have shown that other mesothelioma cancer therapies, including radiation, certain chemotherapies and immunotherapies, could improve TTFields’ effectiveness.

“We are planning many experiments, many different compounds to uncover the best combination in which to use this therapy,” D’Incalci said. “We could be trying ones not even used today for mesothelioma.”

There are almost 50 cancer centers within the U.S. today that are certified to prescribe TTFields to patients. Side effects, beyond those involving the chemotherapy, have been mild.

“We are excited about this opportunity – which patients benefit the most, and why,” D’Incalci said. “What we find could make mesothelioma, a tumor for which therapies are limited today, become the model of use for other diseases.”

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