TumorTreating Fields Delivery Using Second Generation Optune®System for Glioblastoma: Patient Experience and Compliance
Tumor Treating Fields (TTFields) are non-invasive, ow-intensity, frequency tuned (200kHz) electric fields with anti-mitotic activity (Figure1), delivered using the Optune system, and are approved for the treatment of adult patients with newly diagnosed and recurrent supratentorial glioblastoma (GBM).
TTFields are delivered via four transducer arrays that are applied directly to the scalp to target the tumor (Figure1). The original Optune system (NovoTTF100 A system) consists of a field generator, portable lithium batteries, carrying bag, and transducer arrays, and weighed approximately 6lbs (Table1, left).
Asecond-generation Optune system (NovoTTF200 A system) has been developed to improve the convenience and manageability of TTFields therapy for GBM patients (Table1, right). Approved by the FDA in July2016, the system uses new digital signal generation technology reducing the size and weight to 2.7lbs, which may positively affect convenience and compliance with treatment.
DISCUSSION AND IMPLICATIONS FOR ONCOLOGY NURSES
- Patient feedback on the new second-generation Optune system highlighted the system's portability, the quieter operation, and reduction in daily alarms
- Compliance was maintained or increased after the transition to the second-generation system, with 90% of patients achieving the target compliance rate of >75% per day during the first month on therapy
- Oncology nurses provide key education, to patients and caregivers on the benefits of compliance helping them to balance individual goals and schedules, while optimizing the possibility of extended survival
- Many resources are available to educate patients and clinicians on TTFields, including adverse event management, maintenance of desired activity level, and troubleshooting technical issues
- As leaders in transformational cancer care, oncology nurses can continue to advance excellence in oncology nursing by guiding patients and caregivers with new therapies and technologies in the battle against cancer
- TTFields treatment that target compliance rates of 75% (18 hours per day) improve survival outcomes as observed in GBM clinical trials. The results of this patient survey indicate that the improved size, weight and convenience of the second generation Optune system help patients comply with daily treatment duration goals