Study: ‘Sci-fi’ cancer therapy fights brain tumours
More than twice as many patients were alive five years despite cost of procedure
WASHINGTON — It sounds like science fiction, but a cap-like device that makes electric fields to fight cancer improved survival for the first time in more than a decade for people with deadly brain tumours, final results of a large study suggest.
Many doctors are skeptical of the therapy, called tumour treating fields, and it’s not a cure. It’s also ultraexpensive — $21,000 a month.
But in the study, more than twice as many patients were alive five years after getting it, plus the usual chemotherapy, than those given just the chemo — 13 per cent versus five per cent.
“It’s out of the box” in terms of how cancer is usually treated, and many doctors don’t understand it or think it can help, said Dr. Roger Stupp, a brain tumour expert at Northwestern Memorial Hospital in Chicago.
He led the company-sponsored study while previously at University Hospital Zurich in Switzerland, and gave results Sunday at an American Association for Cancer Research meeting in Washington.
“You cannot argue with them — they’re great results,” and unlikely to be due to a placebo effect, said one independent expert, Dr. Antonio Chiocca, neurosurgery chief at Brigham and Women’s Hospital in Boston.
Dr. George Demetri of the Dana-Farber Cancer Institute in Boston and a board member of the association hosting the conference, agreed but called the benefit modest, because most patients still die within five years.
About the treatment
The device, called Optune, is made by Novocure, based in Jersey, an island near England. It’s sold in the U.S., Germany, Switzerland and Japan for adults with an aggressive cancer called glioblastoma multiforme, and is used with chemo after surgery and radiation to try to keep these tumours from recurring, as most do.
Patients cover their shaved scalp with strips of electrodes connected by wires to a small generator kept in a bag. They can wear a hat, go about their usual lives, and are supposed to use the device at least 18 hours a day. It’s not an electric current or radiation, and they feel only mild heat.
It supposedly works by creating low intensity, alternating electric fields that disrupt cell division — confusing the way chromosomes line up — which makes the cells die. Because cancer cells divide often, and normal cells in the adult brain do not, this in theory mostly harms the disease and not the patient.
What studies show
In a 2011 study, the device didn’t improve survival but caused fewer symptoms than chemo did for people whose tumours had worsened or recurred after standard treatments. The U.S. Food and Drug Administration approved it for that situation.
A second study, in newly diagnosed patients, was stopped in 2014 after about half of the 695 participants had been tracked for at least 18 months, because those using the device were living several months longer on average than the rest.
The new results
Now they’re in: Median survival was 21 months for those given Optune plus chemo versus 16 months for those on chemo alone. Survival rates were 43 per cent versus 31 per cent at two years; 26 per cent versus 16 per cent at three years, and 13 per cent versus five per cent at five years.
Side effects were minimal but included blood-count problems, weakness, fatigue and skin irritation from the electrodes.
The price
A big issue is cost — roughly US$700 a day. The price reflects “an extremely sophisticated medical device, made in very low quantities,” with disposable parts changed several times a week and a support person for each patient, said Novocure’s chief executive, Bill Doyle. Plus 17 years of lab, animal and human testing.
You cannot argue with them — they’re great results” Dr. Antonio Chiocca, neurosurgery chief at Brigham and Women’s Hospital