Tumor-Treating Field Therapy Looks Beyond Brain Cancer

Andrew D. Smith
Published: Tuesday, Jul 31, 2018
“Wearing a device nearly 24-7 still strikes many people as a weird way to treat cancer, but then chemotherapy also seemed like a crazy idea at first. The skeptics said that no sane doctor would administer systemic poison and no sane patient would take it. Then all the trials showed significant benefit, and chemotherapy became the most common cancer treatment,” Stupp said. “If TTF can demonstrate therapeutic benefits, it will be adopted by everyone, including doctors and patients who cannot currently imagine treating cancer with a battery pack, some wires, and a few sticky transducer arrays.”

New System in Development

A second electrical field system in development works differently from Novocure’s device. Rather than sending an electrical current from a set of arrays affixed to the afflicted body part, through the tumor, and back into opposing arrays, the TheraBionic system delivers a radiofrequency electromagnetic field (RF EMF) through the entire body via a spoon-shaped device that patients suck on for 3 daily sessions.

TheraBionic was developed by Alexandre Barbault and Boris Pasche, MD, PhD, at nearly the exact same time that Palti was tinkering in his basement with what eventually became the Optune system.

Pasche, who is now the director of Wake Forest Baptist Health’s Comprehensive Cancer Center, was treating patients with cancer in France and Switzerland in 2001. He and his fellow investigators recruited 163 of those patients to try the experimental device by using the argument that it exposed them to less RF EMF currents than a cellphone and that those who benefited might be included in a longer study.

They exposed different patients to different frequencies and eventually found that specific frequencies consistently produced physiological effects in patients with particular tumor types but no effects in healthy patients or in patients with other tumor types. Grade 1 fatigue was observed in 3 patients; there were no grade 2, 3, or 4 toxicities. Pasche and his colleagues kept providing treatment to 28 patients to assess the effect on cancer progression, and 6 of those patients had complete response (n = 1), partial response (n = 1) or sustained stable disease (n = 4).13

The technology was next tested in a single-arm, single-facility trial on 41 patients with advanced hepatocellular carcinoma (HCC) and Child-Pugh A or B disease. Patients self-administered 3 treatments daily at 60 minutes each with the frequency that had been found to affect HCC until patients experienced disease progression or death. Investigators reported that 4 patients had objective responses (including 2 that lasted nearly 5 years) and 14 patients had stable disease for more than 6 months. Median PFS was 4.4 months (95% CI, 2.1-5.3 months) and median OS was 6.7 months (95% CI, 3.0-10.2 months).14

Those trials, along with an in vitro study that further demonstrated that frequencies found to disrupt particular cancers would consistently disrupt their intended targets, but not other cancers, generated significant media coverage.15

Since then, however, North Carolina-based TheraBionic LLC has gone silent—its website hasn’t been updated since 2012—but Pasche says the look of inactivity is deceiving. TheraBionic GmbH has been operating in Germany since 2013 and is seeking permission to sell its device for the treatment of advanced liver cancers in those who have failed on all other treatments.

“The device that generates the RF electromagnetic field is about the size of a portable CD player, and it’s connected to the mouthpiece by a long wire, so patients can sit on a chair with the box beside them and watch TV or read a book while they undergo treatment every day,” said Pasche, who became interested in cancer treatment after his brother died of leukemia while he was attending medical school.

“I did a research fellowship at Memorial Sloan Kettering after medical school, and when I saw how much pain and disability patients suffered from existing treatments, I dreamed of finding a gentle treatment that was still genuinely effective. Chemotherapy in particular seemed slightly barbaric to me and—odd as this probably sounds coming from the director of a cancer center— it still does.”

Differences in Technologies

Although the hypotheses underlying the use of electrical fields are similar to those of TTF therapy, CTECH’s system has a different mechanism: It directs a low-intensity, intermediate-frequency electrostatic wave from 1 capacitive electrode, through a tumor, and into another electrode. The use of capacitive electrodes to distribute the electrical field eliminates the current’s going into the body and, thus, the requirement of direct contact of the electrodes with the skin. The device can be used over clothes or air layers. CTECH has named the system Electro-Capacitive Cancer Therapy.The company has not yet conducted trials in humans, but it has published preclinical study results demonstrating that its system can fight tumors.

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