Tumour Treating Fields for mesothelioma

Our plain-English summary of Tumour Treating Fields for mesothelioma, by M. Barbarino, M. Bottaro, L. Luzzi, et al (The Lancet. Oncology, 2020).

The study

• Authors: M. Barbarino, M. Bottaro, L. Luzzi, A. Giordano, L. Mutti
• Journal: The Lancet. Oncology
• Published: 2020;21(1):e8
• Type of article: Letter, Comment
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a short letter to the editor, not a research study, and it reports no new data. The writers commented on a separate published trial by Ceresoli and colleagues (the STELLAR trial). That trial tested Tumour Treating Fields, a technology that delivers low-intensity electric fields meant to interfere with cell division, in people with inoperable malignant pleural mesothelioma. The writers argued that the trial left out key information, including patients' history of asbestos exposure, precise disease staging and other prognostic factors. They noted that in that trial 56% of patients had a performance status of 0 and 44% a status of 1. They called this unusually high and said better performance status contributes to the long survival reported. They believed the trial population was affected by lead-time bias and said the lack of a control group must soften any conclusion. They also noted that patients were not grouped by mitotic index or markers such as Ki67, and said effects on quality of life should be assessed. The authors concluded that researchers should draw cautious conclusions and attempt patient stratification.

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: Letter to the editor (correspondence) commenting on a published phase 2 trial; no original data
• Who was studied: No population was studied by the letter writers; the letter discusses patients with inoperable malignant pleural mesothelioma in the trial by Ceresoli and colleagues
• Exposure: The treatment discussed is Tumour Treating Fields (low-intensity electric fields that interfere with mitosis) given with chemotherapy. The letter writers say that history of asbestos exposure was not reported in the trial they discuss.
• Main results:
  • The letter writers argued that the trial by Ceresoli and colleagues lacked information on asbestos exposure history, precise staging and other prognostic factors
  • The letter writers pointed out that in the Ceresoli trial, 56% of patients had a performance status of 0 and 44% a status of 1, which they called unusually high
  • The letter writers said the lack of a control group in the Ceresoli trial must soften any conclusion
  • The letter writers noted that patients in the Ceresoli trial were not stratified by mitotic index or other proliferation markers
  • The letter writers said the treatment's net benefit on quality of life should be assessed
• The authors' conclusion: The authors concluded that researchers studying this cancer should draw cautious conclusions consistent with the results and attempt patient stratification

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma.

Related studies

• Tumour Treating Fields in combination with pemetrexed and cisplatin or carboplatin as first-line treatment for unresectable malignant pleural mesothelioma (STELLAR): a multicentre, single-arm phase 2 trial — G.L. Ceresoli, J.G. Aerts, et al. (2019)
• Tumour Treating Fields for mesothelioma: controversy versus opportunity — D.A. Fennell (2019)
• Tumour Treating Fields for mesothelioma - Authors' reply — G.L. Ceresoli, L. Gianoncelli, et al. (2020)
• Tumour Treating Fields for mesothelioma — C.J. de Gooijer, J.A. Burgers (2020)
• Tumour treating fields therapy for glioblastoma: current advances and future directions — O. Rominiyi, A. Vanderlinden, et al. (2021)
• Tumor Treating Fields (TTFields) downregulate the Fanconi Anemia-BRCA pathway and increase the efficacy of chemotherapy in malignant pleural mesothelioma preclinical models — H. Mumblat, A. Martinez-Conde, et al. (2021)

Browse more research in The Lancet. Oncology, or return to medical research.