Mesothelioma Unit, SS Antonio e Biagio e Cesare Arrigo, Alessandria, AL, Italy
Federica Grosso , Sara Delfanti , Giulia Gallizzi , Francesca Marengo , Iacopo Megna , Carlotta Bertolina , Giovanni Luca Ceresoli
Background: Tumor Treating Fields (TTFields) therapy is a noninvasive, locoregional modality comprised of electric fields which disrupt critical cellular processes necessary for cancer cell viability and tumor progression. TTFields therapy is FDA approved and CE-marked for glioblastoma, and pleural mesothelioma. Approval for the latter was based on results from the phase 2 STELLAR study (EF-23, NCT02397928), in which the median OS was 18.2 months (95% CI 12.1–25.8) and median PFS was 7.6 months (95% CI 6.7–8.6). As the electrical fields are delivered non-invasively via skin-adhered arrays, the most common adverse events (AEs) are mild-moderate skin reactions which can be effectively managed with appropriate prophylaxis and timely intervention. Here we report a single-center experience of treating and managing TTFields therapy-related AEs in the STELLAR study, based on a center-specific protocol. Methods: The STELLAR study was a multicenter, single-arm, non-randomized, phase 2 study, whereby patients received TTFields therapy (150 kHz, 18 h/day) concomitant with pemetrexed (500 mg/m2) and platinum-based chemotherapy (75 mg/m2). TTFields-therapy AEs were managed and treated using a center-specific protocol (Table). Results: In this single center, 23 patients were treated using the predefined protocol to prevent skin AEs; all were included in the safety analysis. n = 15 (65%) reported a mild-moderate skin AE (n = 12 [52%] medical device site reaction [skin AE], n = 1 [4%] had mild-moderate rash, rash erythematous and skin irritation) in the single center, vs n = 54 (68%) in the overall STELLAR population. n = 2 (9%) in the single site had a severe medical device site reaction, which was comparable with the overall STELLAR study population. Conclusions: A predefined multidisciplinary approach was successful to help prevent mild-moderate skin AEs. Timely and appropriate management of mild/moderate skin AEs can prevent exacerbations. Skin management may support usage, thus optimizing outcomes for patients. Guidelines on preventing skin AEs when using TTFields therapy are available and should be incorporated in a clinical setting. Clinical trial information: NCT02397928.
Role | Step |
---|---|
Patient | · Remove torso hair |
Patient/clinician | · Monitor skin closely; send pictures after array removal |
Patient | · Clean the skin when changing arrays, apply zinc-based cream |
Patient/caregiver/palliative care nurse | · Thoroughly wash hands before array removal/replacement · Gently remove arrays (aided by caregiver after initial nurse) using medical adhesive removal spray |
Patient | · Allow 6 h between array removal/replacement |
Patient | · Shift arrays placement per suggested layout; during placement of new array, alternate layout by ~2 cm from prior site-of-contact |
Patient | · Remove arrays before scheduled visits to check skin status with dermatologist |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2019 ASCO Annual Meeting
First Author: Federica Grosso
2023 ASCO Annual Meeting
First Author: Patrick M. Forde
2023 ASCO Annual Meeting
First Author: Aaron Scott Mansfield
2023 ASCO Annual Meeting
First Author: Anne M. Noonan