Commenting on the EF14 study was Martin J. van den Bent, MD, of The Brain Tumor Center at Erasmus MC Cancer Institute in Rotterdam, The Netherlands, who was reticent to predict that tumor treating fields will become a standard of care.

He noted that 57% of patients are still alive; therefore, the overall survival data are not mature. The study results were made available prematurely upon the independent data monitoring committee’s recommendation based on an interim analysis, and the control arm was invited to cross over to the intervention. Thus, the study cannot definitely evaluate the survival benefit of the treatment, he said.

Dr. van den Bent also suggested that the intensive monitoring of the active group may have created a favorable situation for this arm, similar to the way in which early palliative care actually improves survival, according to several studies. In this regard, a sham control arm might have been informative.

Practical Details

He was also concerned about the “practical details” of tumor treating fields. “There is continuous treatment, which places a burden on patients. It requires a fully shaved head for the electrodes to fit. Patients must wear a backpack all day (with a few breaks allowed), and electrodes must be changed every few days,” he indicated.

“The device brings lifestyle issues and hassles, but also, is it worth the cost, which is estimated at $20,000 per month?” he asked. ■

Disclosure: Dr. van den Bent reported no potential conflicts of interest.