Advancement in tumor treating fields of mechanism, clinical applications, and future directions

Our plain-English summary of Advancement in tumor treating fields of mechanism, clinical applications, and future directions, by M. Zang, S. Zhu, Q. Niu (Discover Oncology, 2025).

The study

• Authors: M. Zang, S. Zhu, Q. Niu
• Journal: Discover Oncology
• Published: 2025;16(1):1049
• Type of article: Review
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Traditional cancer treatment modalities, such as surgical interventions, radiotherapy, and chemotherapy, persist as the cornerstone of standard care across a wide array of clinical settings. Despite their established effectiveness in combating cancer, these therapies are inherently invasive in nature and have great side effects, which seriously affect the quality of life of patients. Tumor Treating Fields is a low-intensity intermediate-frequency alternating electric field. Based on the current clinical study of Tumor Treating Fields in brain tumors, The U.S. Food and Drug Administration (FDA) initially approved Tumor Treating Fields in 2015 for the treatment of newly diagnosed or relapsed glioblastoma multiforme (GBM) and in 2019 for the treatment of malignant pleural mesothelioma (MPM). However, Tumor Treating Fields is still not widely appreciated in the treatment of high-mortality cancers, and although the therapeutic effect of Tumor Treating Fields has been validated in cell experiments and clinical trials, how to optimize its therapeutic effect remains to be studied. In this paper, the mechanism of Tumor Treating Fields treatment and its clinical progress were reviewed, and the dosimetry and numerical simulation of individualized treatment were comprehensively summarized, in order provide new ideas for further clinical research of this treatment model.

© 2025. The Author(s).

In plain English

This was a review, not a new study. The authors summarized published laboratory, animal and clinical research on Tumor Treating Fields (TTFields), low-intensity alternating electric fields delivered through patches on the skin. It covered glioblastoma, malignant pleural mesothelioma, lung, pancreatic, ovarian, liver and gastric cancers. The article did not discuss asbestos. For malignant pleural mesothelioma, the review reported that the FDA approved TTFields in 2019 for locally advanced or metastatic disease. It described the STELLAR phase II trial, which treated 80 patients with unresectable malignant pleural mesothelioma with TTFields plus pemetrexed and cisplatin or carboplatin. That trial reported a median overall survival of 18.2 months (95% CI 12.1–25.8). In a separate study the review cited, all patients had grade 1–2 skin irritation under the patches and none had grade 3 or higher device-related toxicity. Laboratory work it cited found that TTFields added to the effect of cisplatin or pemetrexed on mesothelioma cells. The authors concluded that TTFields have shown therapeutic potential for various solid tumors. They noted that the device must be worn more than 18 hours a day and that its cost is high.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: narrative review of published cell, animal and clinical studies of Tumor Treating Fields
• Who was studied: No patients were studied by the authors. The review covered published research on several cancers: glioblastoma, mesothelioma, non-small cell lung cancer, pancreatic, ovarian, liver and gastric cancers.
• Exposure: No asbestos exposure was studied. The subject was a treatment: Tumor Treating Fields, intermediate-frequency (100–300 kHz), low-intensity (1–3 V/cm) alternating electric fields, used alone or with chemotherapy, radiation or immunotherapy.
• Main results:
  • The review reported that the FDA approved TTFields in 2019 for locally advanced or metastatic malignant pleural mesothelioma.
  • The review described the STELLAR phase II trial (a study by other researchers), which treated 80 patients with unresectable malignant pleural mesothelioma with TTFields plus pemetrexed and cisplatin or carboplatin. It reported a median overall survival of 18.2 months (95% CI 12.1–25.8).
  • In a feasibility study cited by the review, TTFields given with pemetrexed and platinum-based chemotherapy for unresectable malignant pleural mesothelioma caused grade 1–2 skin irritation in the sensor array region in all patients. No patients had grade 3 or higher device-related toxicity.
  • A laboratory study cited by the review (Mumblat et al.) reported that TTFields combined with cisplatin or pemetrexed enhanced the therapeutic effect on mesothelioma cells in vitro.
• The authors' conclusion: The authors concluded that TTFields have shown therapeutic potential for various solid tumors in basic research and clinical translation, and that individualized computer modelling of the electric field could support treatment planning.
• Limitations the authors state:
  • The authors stated that researchers still lack a comprehensive theory of how TTFields act at the organ scale.
  • The authors noted a practical limit of the treatment itself: patients must wear the device more than 18 hours a day, and long skin contact with the sensor array may cause irritant dermatitis.
  • The authors noted that the high cost of the equipment exceeds what medical insurance in most regions can cover.

Topics

Medical terms in this study, explained in our Lexicon: Tumor Treating Fields (TTFields), Chemotherapy, Quality of Life, Pleural Mesothelioma, Clinical Trial.

Related studies

• A review of tumor treating fields (TTFields): advancements in clinical applications and mechanistic insights — X. Li, K. Liu, et al. (2023)
• Tumour treating fields therapy for glioblastoma: current advances and future directions — O. Rominiyi, A. Vanderlinden, et al. (2021)
• Advancements and current trends in tumor treating fields: a scientometric analysis — Y. Xing, F. Yasinjan, et al. (2024)
• Tumor Treating Fields (TTFields) Therapy in Unresectable Pleural Mesothelioma: Overview of Efficacy, Safety, and Future Outlook — G.L. Ceresoli, L. Gianoncelli (2025)
• The Mechanisms of Action of Tumor Treating Fields — J.C. Moser, E. Salvador, et al. (2022)
• The schemes, mechanisms and molecular pathway changes of Tumor Treating Fields (TTFields) alone or in combination with radiotherapy and chemotherapy — G. Tanzhu, L. Chen, et al. (2022)

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