TTFields for Mesothelioma: Optune Lua

What Are Tumor Treating Fields?

Tumor Treating Fields (TTFields) is an FDA-approved treatment that uses alternating electric fields to disrupt cancer cell division. For mesothelioma, the device is called Optune Lua and is used in combination with standard chemotherapy.

How it works:

• Low-intensity electric fields (200 kHz) are delivered through transducer arrays placed on the skin
• These fields interfere with cancer cell division (mitosis)
• Normal cells are largely unaffected due to their slower division rate
• Treatment is worn continuously for maximum benefit

FDA Approval for Mesothelioma

Optune Lua received FDA approval for malignant pleural mesothelioma in combination with pemetrexed and platinum-based chemotherapy.

This makes TTFields one of the few treatment modalities specifically approved for mesothelioma beyond:

• Chemotherapy (pemetrexed + cisplatin/carboplatin)
• Immunotherapy (nivolumab + ipilimumab)
• Surgery (EPP, P/D)

How TTFields Treatment Works

The Device

The Optune Lua system includes:

• Transducer arrays: Adhesive pads placed on the torso
• Portable battery pack: Allows mobility during treatment
• Connection cables: Link arrays to power source

Treatment Schedule

• Treatment is continuous (worn most of the day)
• Arrays are replaced regularly
• Battery allows normal daily activities
• Patients can work, exercise, and travel

Compliance Matters

Research from glioblastoma studies shows:

• Patients with 75% or higher compliance had significantly better outcomes
• Higher daily use correlates with improved survival
• Treatment works best when worn consistently

What the Evidence Shows

Glioblastoma Data (Reference Point)

The most extensive TTFields data comes from glioblastoma treatment (EF-14 trial):

Measure	TTFields + Chemo	Chemo Alone
Median overall survival	20.5 months	15.6 months
2-year survival	43%	29%

This 5-month survival improvement established TTFields as a viable cancer treatment.

Mesothelioma Application

TTFields is approved for mesothelioma based on:

• Mechanism of action applies to all dividing cancer cells
• Combination with standard chemotherapy
• Favorable safety profile
• Ongoing research in mesothelioma patients

Safety Profile

TTFields has a favorable side effect profile compared to systemic treatments:

Common Side Effects

Side Effect	Frequency	Management
Skin irritation	Common	Array repositioning, topical creams
Skin redness	Common	Breaks between array placement
Itching	Common	Antihistamines if needed

Systemic Effects

Minimal systemic toxicity: Unlike chemotherapy, TTFields:

• Does not cause nausea
• Does not lower blood counts
• Does not cause hair loss
• Does not require hospitalization

This makes TTFields particularly valuable for patients who:

• Cannot tolerate intensive chemotherapy
• Want to maintain quality of life during treatment
• Are using it as part of multimodal therapy

Who Is a Candidate?

Ideal Candidates

• Diagnosed with malignant pleural mesothelioma
• Receiving or planning to receive pemetrexed-based chemotherapy
• Able to comply with continuous treatment schedule
• No pacemaker or other implanted electronic devices

Considerations

Discuss with your oncologist:

• Your overall treatment plan
• How TTFields fits with surgery, chemo, immunotherapy
• Logistics of continuous wear
• Insurance coverage

Practical Considerations

Daily Life with TTFields

Patients can:

• Work and perform daily activities
• Exercise (with precautions for arrays)
• Shower (with temporary array removal)
• Travel (carry spare batteries)

Patients should:

• Wear the device as many hours as possible
• Keep arrays clean and dry
• Replace arrays on schedule
• Report any skin issues promptly

Support Services

Novocure (the manufacturer) provides:

• Patient support specialists
• Technical assistance
• Insurance navigation help
• Educational materials

Combining TTFields with Other Treatments

TTFields + Chemotherapy

The approved use is combination with pemetrexed + cisplatin or carboplatin. This multimodal approach targets cancer through:

• Chemotherapy: Direct cell killing
• TTFields: Disrupting cell division
• Different mechanisms: Potentially synergistic effects

TTFields + Immunotherapy

Research is exploring TTFields combined with checkpoint inhibitors:

• May enhance immune response
• Could improve immunotherapy effectiveness
• Clinical trials are investigating these combinations

TTFields + Surgery

For surgical candidates:

• TTFields may be used before or after surgery
• Could help control microscopic disease
• Discuss timing with your treatment team

Current Research

Ongoing Trials

Novocure continues researching TTFields in various cancers:

• Phase 3 TRIDENT trial (glioblastoma, 2026)
• Studies in pancreatic cancer
• Research in non-small cell lung cancer

Mesothelioma Research

Active areas of investigation:

• Optimal duration of treatment
• Best combinations with other therapies
• Biomarkers predicting response
• Long-term outcomes

Questions for Your Doctor

1. Is TTFields appropriate for my mesothelioma stage and type?
2. How does TTFields fit into my overall treatment plan?
3. What compliance level is needed for best results?
4. Are there clinical trials combining TTFields with other treatments?
5. What is the cost and is it covered by my insurance?
6. What support is available for managing the device?

Comparing Treatment Options

Treatment	Administration	Side Effects	Compliance
TTFields	Continuous wear	Skin irritation	High daily use
Chemotherapy	IV infusions	Nausea, fatigue, blood counts	Scheduled cycles
Immunotherapy	IV infusions	Immune-related	Scheduled cycles
Surgery	One-time	Surgical recovery	N/A

TTFields offers a unique approach with minimal systemic effects, making it a valuable addition to the mesothelioma treatment toolkit.