Real-World Results

Real-world survival and QoL results

3 real-world studies in over 2,000 patients show that the Optune Gio pivotal efficacy and safety was maintained in practice33-35

Efficacy meta-analysis: Consistent efficacy results across multiple real-world studies33

  • A systematic literature review identified 9 clinical studies that reported on OS—including the EF-14 clinical trial
  • Pooled results from the 6 real-world studies show a 5-month benefit in mOS when adding Optune Gio to the Stupp protocol,* consistent with pivotal trial results
  • Median OS: 22.6 months with Optune Gio + Stupp protocol vs 17.4 months with Stupp protocol alone
Table of OS comparison for Optune Gio + SOC vs SOC alone, with pooled median, 2-year, and 4-year OS rates.

~5-month increase in median OS with Optune Gio was consistent between the real-world setting and the pivotal EF-14 trial33

Extend past the clinical trial to the real-life setting

TIGER: the largest, prospective real-world study of Optune Gio: Robust OS and PFS results across real-world patients with a broad range of clinical characteristics that was consistent with EF-1434

  • Median OS: 19.6 months for Optune Gio + TMZ
  • Median PFS: 10.2 months for Optune Gio + TMZ

 

While SAEs were observed in TIGER, the vast majority were not attributed to Optune Gio. Only 3 SAEs (0.7%) were attributed to Optune Gio, and all were considered mild to moderate in severity. No deaths were associated with device-related SAEs1,34

  • Only SAEs (grade 3-5) were measured in the TIGER study. The rates of mild-to-moderate AEs (grade 1-2) were not recorded. In the EF-14 trial, the most common AEs associated with Optune Gio device use were skin related and mild to moderate

Limitations:

  • The TIGER study was an observational and nonrandomized study conducted in Germany and did not include a control group. As with all observational research, comparisons to other interventional and noninterventional studies should be made with caution34
  • The TIGER study is not yet fully published. There may be additional study details and/or limitations other than those included in the poster

The TIGER study showed Optune Gio is both effective and well-tolerated in the real-world clinical setting1,34

QoL real-world study: Data from over 1,000 patients showed real-world QoL can be maintained while on Optune Gio35

  • To assess QoL in patients actively using Optune Gio for treatment of GBM, EQ-5D-5L and EQ-VAS questionnaires were sent to 2,182 patients in the US and 633 patients in the EU, 1106 of whom were included in the final analysis35
  • Mean time on Optune Gio in this real-world study was 13.5 months and in EF-14 was 12.5 months2,35
  • The current Optune Gio model is half the size and weight of the model used in this study

 

HR-QoL was positively associated with longer time on Optune Gio35†‡

Overall Health Score§

2.63

(higher values indicate improved self-rated health)

Self-care

-0.17

(lower values indicate less impairment)

Mobility

-0.12

(lower scores indicate improved self-rated health)

Usual Activities

-0.17

(lower values indicate less impairment)

Limitations35:

  • While the study was designed for ease of completion, patient privacy, and compliance with approved labeling, that meant some details remain unknown about each patient’s disease, treatment, or supportive care that could impact HR-QoL
  • Because all information was self-reported, it was not possible to verify responses with medical records
  • There may be a response bias, as patients who decided to respond to the survey may not be representative of all patients receiving Optune Gio in the US and the EU

Real Patient Cases

*Predominantly included maximal surgical resection followed by standard RT + concurrent TMZ and adjuvant TMZ.33

 

In the univariate analysis based on log (time on Optune Gio). 

 

As measured by EuroQol’s EQ-5D-5L questionnaire and EuroQol’s visual analogue scale (EQ-VAS), a standard questionnaire in which patients can rate their overall health score. 

 

§As measured by EQ-VAS.

 

GBM, glioblastoma; mOS, median overall survival; OS, overall survival; QoL, quality of life; RT, radiation therapy; TMZ, temozolomide. AEs, adverse events; EQ-5D-5L, EuroQol 5-dimensional, 5-level survey; EU, European Union; HR-QoL, health-related quality of life; PFS, progression-free survival; SAEs, serious adverse events; TIGER, TTFields In GErmany in Routine Clinical Care (NCT03258021); US, United States.

Indications For Use

Optune Gio® is intended as a treatment for adult patients (22 years of age or older) with histologically confirmed glioblastoma multiforme (GBM).

 

Optune Gio with temozolomide is indicated for the treatment of adult patients with newly diagnosed, supratentorial glioblastoma following maximal debulking surgery, and completion of radiation therapy together with concomitant standard of care chemotherapy.

 

For the treatment of recurrent GBM, Optune Gio is indicated following histologically or radiologically confirmed recurrence in the supratentorial region of the brain after receiving chemotherapy. The device is intended to be used as a monotherapy and is intended as an alternative to standard medical therapy for GBM after surgical and radiation options have been exhausted.
 

Important Safety Information

Contraindications

Do not use Optune Gio in patients with an active implanted medical device, a skull defect (such as, missing bone with no replacement), or bullet fragments. Use of Optune Gio together with implanted electronic devices has not been tested and may theoretically lead to malfunctioning of the implanted device. Use of Optune Gio together with skull defects or bullet fragments has not been tested and may possibly lead to tissue damage or render Optune Gio ineffective.

 

Do not use Optune Gio in patients that are known to be sensitive to conductive hydrogels. In this case, skin contact with the gel used with Optune Gio may commonly cause increased redness and itching, and rarely may even lead to severe allergic reactions such as shock and respiratory failure.

 

Warnings and precautions

Optune Gio can only be prescribed by a healthcare provider that has completed the required certification training provided by Novocure (the device manufacturer).

 

Do not prescribe Optune Gio for patients that are pregnant, you think might be pregnant or are trying to get pregnant, as the safety and effectiveness of Optune Gio in these populations have not been established.

 

The most common (≥10%) adverse events involving Optune Gio in combination with temozolomide were thrombocytopenia, nausea, constipation, vomiting, fatigue, medical device site reaction, headache, convulsions, and depression.

 

The most common (≥10%) adverse events seen with Optune Gio monotherapy were medical device site reaction and headache.
The following adverse reactions were considered related to Optune Gio when used as monotherapy: medical device site reaction, headache, malaise, muscle twitching, fall, and skin ulcer.

 

Use of Optune Gio in patients with an inactive implanted medical device in the brain has not been studied for safety and effectiveness, and use of Optune Gio in these patients could lead to tissue damage or lower the chance of Optune Gio being effective.

 

If the patient has an underlying serious skin condition on the scalp, evaluate whether this may prevent or temporarily interfere with Optune Gio treatment.

Please click here to see the Optune Gio® Instructions For Use for complete information regarding the device’s indications, contraindications, warnings, and precautions.

 

References

1. Optune Gio. Instructions For Use. Novocure; 2023. 2. Taphoorn MJB, Dirven L, Kanner AA, et al. Influence of treatment with tumor-treating fields on health-related quality of life of patients with newly diagnosed glioblastoma: a secondary analysis of a randomized clinical trial. JAMA Oncol. 2018;4(4):495-504. doi:10.1001/jamaoncol.2017.5082 3. Stupp R, Taillibert S, Kanner A, et al. Effect of tumor-treating fields plus maintenance temozolomide vs maintenance temozolomide alone on survival in patients with glioblastoma: a randomized clinical trial. JAMA. 2017;318(23):2306-2316. doi:10.1001/ jama.2017.18718 4. Novocure Data on File US-DOF-0035. 5. Novocure Data on File US-DOF-0038. 6. Stupp R, Idbaih A, Steinberg DM, et al. Prospective, multi-center phase III trial of tumor treating fields together with temozolomide compared to temozolomide alone in newly diagnosed glioblastoma. Presented at: 2017 Annual Meeting of the American Association for Cancer Research; April 1-5, 2017; Washington, DC. Oral presentation LBA AACR CT007. 7. Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005;352(10):987-996. doi:10.1056/NEJMoa043330 8. Sulman EP, Ismaila N, Armstrong TS, et al. Radiation therapy for glioblastoma: American Society of Clinical Oncology Clinical Practice Guideline endorsement of the American Society for Radiation Oncology Guideline. J Clin Oncol. 2017;35(3):361-369. doi:10.1200/JCO.2016.70.7562 9. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Central Nervous System Cancers. V.3.2024. © National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed November 27, 2024. To view the most recent and complete version of the guideline, go online to NCCN.org. 10. Kinzel A, Ambrogi M, Varshaver M, Kirson ED. Tumor treating fields for glioblastoma treatment: patient satisfaction and compliance with the second-generation Optune® system. Clin Med Insights Oncol. 2019:13: 1179554918825449. doi:10.1177/1179554918825449 11. Novocure Data on File US-DOF-0049. 12. Optune. Patient Information and Operation Manual for Glioblastoma Multiforme. Novocure; 2023. 13. Karanam NK, Story MD. An overview of potential novel mechanisms of action underlying tumor treating fields-induced cancer cell death and their clinical implications. Int J Radiat Biol. 2021;97(8):1044-1054. doi:10.1080/09553002.2020.1837984 14. Ahmad MA, Al Natour Z, Mustafa F, Rizvi TA. Electrical characterization of normal and cancer cells. IEEE Access. 2018;6:25979-25986. doi:10.1109/ACCESS.2018.2830883 15. Kirson ED, Gurvich Z, Schneiderman R, et al. Disruption of cancer cell replication by alternating electric fields. Cancer Res. 2004;64(9):3288-3295. doi:10.1158/0008-5472.can-04-0083 16. Gera N, Yang A, Holtzman TS, Lee SX, Wong ET, Swanson KD. Tumor treating fields perturb the localization of septins and cause aberrant mitotic exit. PLoS One. 2015;10(5):e0125269. doi:10.1371/journal.pone.0125269 17. Giladi M, Schneiderman RS, Voloshin T, et al. Mitotic spindle disruption by alternating electric fields leads to improper chromosome segregation and mitotic catastrophe in cancer cells. Sci Rep. 2015;5:18046. doi:10.1038/srep18046 18. Novocure Data on File US-DOF-0052. 19. Vanderbeek AM, Rahman R, Fell G, et al. The clinical trials landscape for glioblastoma: is it adequate to develop new treatments? Neuro Oncol. 2018;20(8):1034-1043. doi:10.1093/neuonc/noy027 20. Stupp R, Taillibert S, Kanner A, et al. Effect of tumor-treating fields plus maintenance temozolomide vs maintenance temozolomide alone on survival in patients with glioblastoma: a randomized clinical trial. Supplement 1. Trial protocol and statistical analysis plan. JAMA. 2017;318(23):2306-2316. Accessed January 9, 2025. https://jamanetwork.com/journals/jama/fullarticle/2666504 21. Toms SA, Kim CY, Nicholas G, Ram Z. Increased compliance with tumor treating fields therapy is prognostic for improved survival in the treatment of glioblastoma: a subgroup analysis of the EF-14 phase III trial. J Neurooncol. 2019;141(2):467-473. doi:10.1007/s11060-018-03057-z 22. Ram Z, Kim CY, Hottinger AF, Idbaih A, Nicholas G, Zhu JJ. Efficacy and safety of Tumor Treating Fields (TTFields) in elderly patients with newly diagnosed glioblastoma: subgroup analysis of the phase 3 EF-14 clinical trial. Front Oncol. 2021;11:671972. doi:10.3389/fonc.2021.671972 23. Taphoorn MJB, Dirven L, Kanner AA, et al. Influence of treatment with tumor-treating fields and health-related quality of life of patients with newly diagnosed glioblastoma: a secondary analysis of a randomized clinical trial. Supplementary online content. JAMA Oncol. 2018;4(4):495-504. Accessed January 9, 2025. https://jamanetwork.com/journals/jamaoncology/fullarticle/2670704 24. EORTC Quality of Life Group. EORTC QLQ-C30, Version 3.0. 1995. European Organisation for Research and Treatment of Cancer, Belgium. https://www.eortc.org/app/uploads/sites/2/2018/08/Specimen-QLQ-C30-English.pdf 25. Zhu JJ, Demireva P, Kanner AA, et al. Health-related quality of life, cognitive screening, and functional status in a randomized phase III trial (EF-14) of tumor treating fields with temozolomide compared to temozolomide alone in newly diagnosed glioblastoma. J Neurooncol. 2017;135(3):545-552. doi:10.1007/s11060-017-2601-y 26. Novocure Data on File OPT-103. 27. Lacouture ME, Anadkat MJ, Ballo MT, et al. Prevention and management of dermatologic adverse events associated with Tumor Treating Fields in patients with glioblastoma. Front Oncol. 2020;10:1045. doi:10.3389/fonc.2020.01045 28. Stupp R, Wong ET, Kanner AA, et al. NovoTTF-100A versus physician’s choice chemotherapy in recurrent glioblastoma: a randomised phase III trial of a novel treatment modality. Eur J Cancer. 2012;48(14):2192-2202. doi:10.1016/j.ejca.2012.04.011 29. Stupp R, Wong ET, Kanner AA, et al. NovoTTF-100A versus physician’s choice chemotherapy in recurrent glioblastoma: a randomised phase III trial of a novel treatment modality. Supplementary Table 1. Eur J Cancer. 2012;48(14):2192-2202. Accessed January 10, 2025. https://www.ejcancer.com/article/S0959-8049(12)00352-8/fulltext 30. Wong ET, Lok E, Swanson KD, et al. Response assessment of NovoTTF-100A versus best physician’s choice chemotherapy in recurrent glioblastoma. Cancer Med. 2014;3(3):592-602. doi:10.1002/cam4.210 31. Kanner AA, Wong ET, Villano JL, Ram Z; EF-11 Investigators. Post hoc analyses of intention-to-treat population in phase III comparison of NovoTTF-100A™ system versus best physician’s choice of chemotherapy. Semin Oncol. 2014;41(suppl 6):S25-S34. doi:10.1053/j. seminoncol.2014.09.008 32. Novocure Data on File OPT-109. 33. Ballo MT, Conlon P, Lavy-Shahaf G, Kinzel A, Vymazal J, Rulseh AM. Association of Tumor Treating Fields (TTFields) therapy with survival in newly diagnosed glioblastoma: a systematic review and meta-analysis. J Neurooncol. 2023;164(1):1-9. doi:10.1007/s11060-023-04348-w 34. Bähr O, Tabatabai G, Fietkau R, Goldbrunner R, Glas M. Tumor Treating Fields therapy in patients with newly diagnosed glioblastoma: long-term survival results from TTFields in Germany in Routine Clinical Care (TIGER) study. Poster presented at: American Society of Clinical Oncology; May 31–June 4, 2024; Chicago, IL. 35. Palmer JD, Chavez G, Furnback W, et al. Health-related quality of life for patients receiving tumor treating fields for glioblastoma. Front Oncol. 2021;11:772261. doi:10.3389/fonc.2021.772261

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US-OPG-00982 v1.0 July 2025

US-OPG-00982 v1.0 July 2025