Tumor Treating Fields for Mesothelioma

Tumor treating fields are a new therapy for malignant mesothelioma. The NovoTTF-100L System is a government-approved treatment for pleural mesothelioma. Doctors often refer to this treatment by its brand name, Optune Lua.

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Written by Jenna Campagna, RN

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Important Facts About Tumor Treating Fields for Mesothelioma

  • The FDA approved a tumor treating fields device, the NovoTTF-100L System, in May 2019. It is now called Optune Lua.
  • The new mesothelioma treatment sends electric waves through the body, affecting cell growth and division.
  • The median survival time is 18.2 months for Optune Lua, and most patients respond positively. It’s also safe to use, with few side effects.
  • More than 80 hospitals offer the therapy for malignant pleural mesothelioma, specifically unresectable cases.

FDA Approval of NovoTTF-100L for Pleural Mesothelioma

In May 2019, the United States Food and Drug Administration (FDA) approved NovoTTF-100L as a Humanitarian Use Device for treating pleural mesothelioma. The approval was the first approved treatment for pleural mesothelioma in 15 years.

Humanitarian use devices are therapies approved to treat conditions that affect fewer than 8,000 people in the United States each year. Mesothelioma affects between 2,500 and 3,000 each year.

The FDA limited use of NovoTTF-100L to specific cases meeting the following criteria:

  • Locally advanced or metastatic disease
  • Surgery isn’t an option
  • The device is paired with standard mesothelioma chemotherapy (pemetrexed and cisplatin)

In September 2019, the West Cancer Center (Germantown, Tennessee) became the first institution to prescribe a pleural mesothelioma patient with NovoTTF-100L.

Brand Name Change to Optune Lua

NovoTTF-100L for pleural mesothelioma received a name change in March of 2020. Novocure rebranded the device as Optune Lua.

Novocure’s chief commercial officer, Pritesh Shah, explained the reason for the name change. He said Optune Lua is “easy to pronounce and remember,” which should help patients and caregivers ask about it by name.

“The Optune brand emphasizes the unique product offerings of Novocure’s tumor treating fields delivery systems and suggests the prospect of hope and optimized care,” Shah said.

What Are Tumor Treating Fields?

Tumor treating fields, called “TTFields” for short, are low-intensity electric fields delivered from a machine or device. These fields, or currents, are delivered at an intermediate frequency. They are “alternating fields,” which mean they periodically reverse direction.

The website Clinical Cancer Research called tumor treating fields the “fourth modality” of cancer treatment. The first three are the standard approaches for pleural mesothelioma:

How Do Tumor Treating Fields Stop Tumors?

Tumor treating fields disrupt cell division, which is the process mesothelioma cells use to duplicate and spread in your body. Mesothelial cells line each side of your pleura, which is the thin lining covering your lungs. This membrane is made up of two cell walls, called the parietal pleura and visceral pleura. Either cell wall is where pleural mesothelioma forms.

Mesothelial cells turn cancerous when sharp asbestos fibers irritate them. They mutate, duplicate and outlive their normal cell life cycle, which leads to an overabundance of diseased cells proliferating in the body.

By preventing mesothelioma cells from dividing, tumor treating fields halt the spread of this cancer. This result stagnates mesothelioma’s growth and prevents tumors from invading the tissue of vital organs.

“Basically, these fields disrupt the normal division process of cells and have the potential to inhibit the growth of tumors and even reverse their progression,” said Dr. Uri Weinberg, the Novocure vice president of clinical development. “Hopefully, this leads to extended survival of patients.”

What Is NovoTTF-100L/Optune Lua?

Optune Lua utilizes “tumor treating fields” to attack tumors in the chest cavity, which is where pleural mesothelioma forms. The device is manufactured by Novocure, which is an oncology company that creates tumor treating fields devices for cancer treatment. The device is the company’s first for any type of mesothelioma.

“NovoCure has been working on tumor treating fields for close to the past 20 years now,” said Dr. Uri Weinberg, who heads the company’s development and research.

How the Optune Lua Work for Mesothelioma

Optune Lua delivers tumor treating fields from four transducer arrays placed on your chest above the affected lung. These arrays are connected to “a small, lightweight” device, as Dr. Weinberg describes, that operates by battery or power outlet connection.

Patients receive the therapy for approximately 18 hours a day. You can wear this device at any time of the day, or night, and it should not impede your ability to go about your usual routine. You can even sleep with it running.

Benefits of Optune Lua for Pleural Mesothelioma

One of the main benefits of tumor treating fields is the little-to-no downside of this therapy. Tumor treating fields will not damage healthy tissue like other mesothelioma treatment options. Tumor treating fields also don’t risk intraoperative complications.

“Most patients do not feel anything unusual while receiving their therapy,” Dr. Weinberg said to Mesothelioma Guide. “This is one of the major assets of the therapy: allowing patients to maintain their quality of life and allowing patients to function while receiving the therapy without disruption of their day-to-day activities.”

Other advantages of tumor treating fields, and Optune Lua in particular, include:

  • Ability to wear the device during normal daily activities, such as working or spending time with family
  • Noninvasive, nearly unnoticeable device and electrical currents
  • Ability to wear the device and receive treatment while sleeping

Which Hospitals Offer Tumor Treating Fields for Mesothelioma?

As of March 2021, Novocure’s tumor treating fields device is available for pleural mesothelioma patients in more than 30 U.S. states.

Some of the Mesothelioma Centers of Excellence, top-ranked medical institutions, offering Optune Lua are:

You can easily access tumor treating fields for pleural mesothelioma. Our staff can recommend one of the top cancer centers to you — and will prioritize finding one that offers the Optune Lua device.

Survival From Tumor Treating Fields

Tumor treating fields can significantly improve your mesothelioma prognosis. The Optune Lua device received FDA approval due to its excellent survival results in the phase 2 STELLAR clinical trial. The study included 80 participants, all of whom received chemotherapy in addition to wearing the device.

Mesothelioma survival rates from the trial show the utility of tumor treating fields. The median survival time was 18.2 months, which is better than most patients who fit the criteria for the device.

The therapy is explicitly for patients who have a locally advanced or metastatic pleural mesothelioma — and who cannot undergo surgery. This most describes a stage 3 or stage 4 disease, which has a survival time of between a few months to a little more than one year.

Epithelioid mesothelioma patients averaged a survival time of close to 21 months. This is an improvement from the general survival time of 19 months.

Sarcomatoid and biphasic patients combined for an average survival length of around 12 months. This result also was an improvement, of a couple months, compared to overall mesothelioma survival times.

Other noteworthy survival stats and disease-response data regarding tumor treating fields for pleural mesothelioma include:

  • 62% one-year survival rate (the general one-year survival rate is 40%)
  • 97% disease control rate, meaning the cancer did not grow and spread further
  • 57% stable disease, meaning the treatment stalled at its current size
  • 40% partial response, meaning the therapy caused the disease to shrink slightly in size

We can provide you more information on other life-extending mesothelioma treatment, such as surgery, chemotherapy, radiation and emerging therapies. Request our free Guide to Mesothelioma book for more medical tips, insight and survival times from our expert staff.

Common Questions About Tumor Treating Fields for Mesothelioma

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How do tumor treating fields work?

Tumor treating fields send low-intensity electric frequencies into the tumor site. These waves, or tumor treating fields, disrupt cell division and can cause cancerous cells to die before replicating. This process slows the spread of mesothelioma and can extend patients’ lives by multiple months or years.

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What was the first tumor treating fields device approved for mesothelioma?

The U.S. Food and Drug Administration approved a tumor treating fields device in May 2019. It received approval after outperforming chemotherapy in mesothelioma clinical trials. The device was originally called NovoTTF-100L System. It’s now called Optune Lua. The device is only for cases where surgery is not an option for patients, and it must be used in cohesion with chemotherapy.

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What are the survival times for Optune Lua for mesothelioma?

The median mesothelioma survival time in the most recent clinical trial was 18 months, which is an improvement from chemotherapy. Epithelioid patients survived for an average of 21 months. The device also led to a 62% one-year survival rate, 97% disease control rate and 57% stable disease rate.

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Where can I get Optune Lua for my mesothelioma?

The tumor treating fields device is available in more than 80 hospitals covering more than half the country. Major cancer centers, such as Brigham and Women’s Hospital in Boston and Moffitt Cancer Center in Tampa, offer the treatment. Our patient advocates can help you find a hospital with this device.

Sources & Author

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About the Writer, Jenna Campagna, RN

Jenna Campagna is a registered nurse and patient advocate who is passionate about helping mesothelioma patients navigate their health care. She has over seven years of experience working with patients diagnosed with rare diseases including mesothelioma. Jenna is also a member of the Academy of Oncology Nurse & Patient Navigators and her goal is to connect patients to top mesothelioma specialists, treatment facilities, and clinical trials. Through her writing, she aims to simplify the complicated journey through mesothelioma by offering helpful tips and advice.