With almost one year of use in the Mid-South, Optune™ therapy through West Cancer Center is improving survival rates for newly diagnosed adults with glioblastoma multiforme (GBM) brain cancer, a fast-growing and common type of primary brain tumors in adults.
The West Cancer Center and the brain and spine specialists at Semmes Murphey Clinic are collaborating to create West Cancer Center’s Comprehensive Neuro-Oncology Program.
Led by Manjari Pandey, MD, an oncologist at West Cancer Center; the center’s director of radiation oncology, Matthew Ballo, MD; and Semmes Murphey neurosurgeons Jeff Sorenson, MD, and Madison Michael, MD, the program is a multidisciplinary approach to cancer treatment. Currently, Optune is available only through West Cancer Center in the Mid-South area.
The collaboration between West and Semmes Murphey to form the Comprehensive Neuro-Oncology Program centers on patients.
“Our collaborative efforts are geared toward identifying newer indications for this technology and to identify more patients who would benefit,” Pandey said. She notes that patients with brain tumors usually start at Semmes Murphey, where a surgeon operates on the tumor. Then the patients are transferred to West Cancer Center for follow-up care and with GBM, for Optune therapy.
The Comprehensive Neuro-Oncology Program will continue to concentrate on research around Optune, but it is only the first step in the long-term plan for the collaboration. West Cancer Center is a leader in the area of research, helping patients gain access to clinical trials, including Phase I through Phase III studies.
“Because of the success associated with this type of treatment, we felt it was the right fit for West Cancer Center and for our patients,” said Erich Mounce, CEO of West Cancer Center. “This is another example of the groundbreaking work our physicians and researchers are doing every single day right here in Memphis.”
It’s taken more than 10 years for an FDA-approved treatment for GBM patients that would significantly extend survival rates. When the Optune technology was in clinical trials, physicians were excited about a new treatment to stop the fast-growing and often difficult to reach brain tumor. Unfortunately, the Optune study released in 2011 did not have impressive data and few physicians were using the treatment, Pandey said.
The research was updated in 2014, with FDA approval in 2015. That approval was based on results of a randomized Phase III study that indicated overall survival rates for newly diagnosed GBM patients treated with Optune were as much as 50 percent higher than those treated with standard chemotherapy alone.
The Optune device looks like a hat or helmet, with electrodes that create an electric field around the tumor to disrupt growth of cancer cells, without damaging healthy cells. Insulated transducer arrays (electrodes) are placed on the scalp to deliver Tumor Treating Fields (TTFields) therapy, which are low intensity, alternating electric fields within the intermediate frequency range.
According to Novocure, the manufacturer of Optune, “TTFields disrupt cell division through physical interactions with key molecules during mitosis. This non-invasive treatment targets solid tumors.”
TTFields are described as the “fourth modality” after surgery, radiation and chemotherapy. Novocure Executive Chairman and founder Bill Doyle describes this new cancer treatment in a TEDMED talk. Optune is based on TTFields to target GBM, the most virulent form of brain cancer, but Pandey cites studies testing the treatment for breast and melanoma cancers, and lung and pancreatic cancers also possibly benefiting from TTFields treatment.
The device is portable, operated by a battery and placed in a bag or backpack so patients can be mobile while receiving treatment. The second generation device was rolled out this summer in the United States and is smaller and lighter, weighing only 2.7 pounds. Oncologists usually recommend wearing the device for 18 hours per day for at least four weeks. Side effects are mild, with Pandey noting some Memphis patients have reported skin irritation, fatigue and headaches.
Patients diagnosed with GBM undergo surgery and radiation before starting Optune treatment. Around four weeks after radiation, Pandey said, Optune therapy is combined with chemotherapy in a two-pronged approach – chemo kills the cancerous cells and the electric field from the electrodes in Optune prevents the cells from dividing.
Healthy brain cells do not divide, so Optune targets only the cancerous cells, preventing the tumor from growing.
When asked about the success of Optune with local patients over the past year, Pandey said, “It’s going surprisingly well, actually. I think the biggest issue today with the GBM is there are not that many treatment options. It’s an extremely aggressive tumor, almost universally fatal with few effective treatments. Even though it’s totally new and totally different and you go out wearing it and people are like ‘what are you wearing?’ but people are willing to wear it to treat their cancer.”
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