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A Prospective, Multi-center Trial of NovoTTF-100A Compared to Best Standard of Care in Patients With Progressive or Recurrent GBM

Phase 3
18 Years
Not Enrolling
Recurrent Glioblastoma Multiforme

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Trial Information

A Prospective, Multi-center Trial of NovoTTF-100A Compared to Best Standard of Care in Patients With Progressive or Recurrent GBM


The effect of the electric fields generated by the NovoTTF-100A device (TTFields) has been
tested in two pilot trials in humans. The data from these trials suggest NovoTTF-100A may
improve time to disease progression and overall survival of recurrent GBM patients. Although
the number of patients in the pilot trials is small, The FDA has determined that the data
gathered so far warrant testing of NovoTTF-100A treatment as a possible therapy for patients
with recurrent GBM.


Patients with GBM whose disease has recurred or progressed despite standard treatment
(Surgery, radiation therapy, Temozolomide treatment) and meet all of the requirements for
participation in the study will be randomly assigned to one of two groups:

1. Treatment with the NovoTTF-100A device, or

2. Treatment with the best standard of care practiced at each of the participating

If assigned to the best standard of care group, patients will receive a chemotherapeutic
agent chosen based on their prior treatments and the standard of care practiced at each
treating center.

If assigned to the NovoTTF-100A group, the patients will be treated continuously for as long
as their disease is stable or regressing. NovoTTF-100A treatment will consist of wearing
four electrically insulated electrodes on the head. Electrode placement will require shaving
of the scalp before treatment. After an initial short hospitalization (24 hours) patients
will be released to continue treatment at home where they can maintain their regular daily

During the trial, regardless of whether assigned to the NovoTTF-100A treatment group or the
best standard of care group, patients will need to return once every month the hospital
outpatient clinics where they will be examined by a physician and undergo routine laboratory
examinations. These routine visits will continue for as long as the patient's disease is not
progressing. After progression, if such occurs, patients will need to return once per month
for two more months to the outpatient clinic for similar follow up examinations.

During the visits to the clinic patients will be examined physically and neurologically.
Additionally, routine blood tests and ECG will be performed. A routine MRI of the head will
be performed at baseline and after 2, 4 and 6 months. After this follow up plan, patients
will be contacted once per month by telephone to answer basic questions about their health


Electric fields exert forces on electric charges similar to the way a magnet exerts forces
on metallic particles within a magnetic field. These forces cause movement and rotation of
electrically charged biological building blocks, much like the alignment of metallic
particles seen along the lines of force radiating outwards from a magnet.

Electric fields can also cause muscles to twitch and if strong enough may heat tissues.
TTFields are alternating electric fields of low intensity. This means that they change their
direction repetitively many times a second. Since they change direction very rapidly (200
thousand times a second), they do not cause muscles to twitch, nor do they have any effects
on other electrically activated tissues in the body (brain, nerves and heart). Since the
intensities of TTFields in the body are very low, they do not cause heating.

The breakthrough finding made by NovoCure was that finely tuned alternating fields of very
low intensity, now termed TTFields (Tumor Treating Fields), cause a significant slowing in
the growth of cancer cells. Due to the unique geometric shape of cancer cells when they are
multiplying, TTFields cause the building blocks of these cells to move and pile up in such a
way that the cells physically explode. In addition, cancer cells also contain miniature
building blocks which act as tiny motors in moving essential parts of the cells from place
to place. TTFields cause these tiny motors to fall apart since they have a special type of
electric charge.

As a result of these two effects, cancer tumor growth is slowed and can even reverse after
continuous exposure to TTFields.

Other cells in the body (normal healthy tissues) are affected much less than cancer cells
since they multiply at a much slower rate if at all. In addition TTFields can be directed to
a certain part of the body, leaving sensitive areas out of their reach.

In conclusion, TTField hold the promise of serving as a brand new cancer treatment with very
few side effects and promising affectivity in slowing or reversing this disease.

Inclusion Criteria:

- Pathological evidence of GBM using WHO classification criteria.

- > 18 years of age.

- Not a candidate for further radiotherapy or additional resection of residual tumor.

- Patients with disease progression (by Macdonald criteria i.e., > 25% or new lesion)
documented by CT or MRI within 4 weeks prior to enrollment

- Karnofsky scale ≥ 70

- Life expectancy at least 3 months

- Participants of childbearing age must use effective contraception.

- All patients must sign written informed consent.

Exclusion Criteria:

- Actively participating in another clinical treatment trial

- Within 4 weeks from surgery for recurrence

- Within 4 weeks from any prior chemotherapy.

- Within 4 weeks from radiation therapy

- Pregnant

- Significant co-morbidities (within 4 weeks prior to enrollment):

1. Significant liver function impairment - AST or ALT > 3 times the upper limit
of normal

2. Total bilirubin > upper limit of normal

3. Significant renal impairment (serum creatinine > 1.7 mg/dL)

4. Coagulopathy (as evidenced by PT or APTT >1.5 times control in patients not
undergoing anticoagulation)

5. Thrombocytopenia (platelet count < 100 x 103/μL)

6. Neutropenia (absolute neutrophil count < 1 x 103/μL)

7. Anemia (Hb < 10 g/L)

8. Severe acute infection

- Implanted pacemaker, defibrillator or deep brain stimulator, or documented clinically
significant arrhythmias.

- Infra-tentorial tumor

- Evidence of increased intracranial pressure (midline shift > 5mm, clinically
significant papilledema, vomiting and nausea or reduced level of consciousness)

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Overall Survival

Outcome Time Frame:

2 years from initiation of accrual

Safety Issue:


Principal Investigator

Phillip Gutin, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Memorial Sloan-Kettering Cancer Center


United States: Food and Drug Administration

Study ID:




Start Date:

September 2006

Completion Date:

January 2011

Related Keywords:

  • Recurrent Glioblastoma Multiforme
  • Brain tumor
  • Treatment
  • Minimal toxicity
  • GBM
  • Glioblastoma
  • Recurrent
  • TTFields
  • Glioblastoma



Memorial Sloan Kettering Cancer CenterNew York, New York  10021
Beth Israel Deaconess Medical CenterBoston, Massachusetts  02215
Medical College of WisconsinMilwaukee, Wisconsin  53226
University Hospitals of ClevelandCleveland, Ohio  44106
Evanston Northwestern HealthcareEvanston, Illinois  60201
University of VirginiaCharlottesville, Virginia  22908
Northwestern UniversityChicago, Illinois  60611
Cleveland ClinicCleveland, Ohio  44195
Columbia University Medical CenterNew York, New York  10032
Lahey Clinic Medical CenterBurlington, Massachusetts  01805
Boston University Medical CenterBoston, Massachusetts  02118
Weill Cornell Medical CollegeNew York, New York  10021
University of Illinois in ChicagoChicago, Illinois  60612
NJ Neuroscience Institute - JFK Medical CenterEdison, New Jersey  08818
University of Pittsburgh Medical Center (UPMC)Pittsburgh, Pennsylvania  15232