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V. Gondi

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    Poster Display Session (ID 63)

    • Event: ELCC 2017
    • Type: Poster Display Session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 5/07/2017, 12:30 - 13:00, Hall 1
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      159TiP - TTFields and radiosurgery for 1-10 brain metastases from NSCLC: The Phase 3 METIS study (ID 409)

      12:30 - 13:00  |  Author(s): V. Gondi

      • Abstract

      Tumor Treating Fields (TTFields) are non-invasive, loco- regional, anti-mitotic treatment modality, based on low intensity alternating electric fields. Efficacy of TTFields in non-small cell lung cancer (NSCLC) has been demonstrated in multiple in vitro and in vivo models, and in a phase I/II clinical study. TTFields treatment to the brain was shown to be safe and to extend overall survival in newly-diagnosed glioblastoma patients.

      Trial design:
      The study objectives are to test the efficacy, safety and neurocognitive outcomes of TTFields in this patient population. Patients (N = 270) with 1-10 brain metastases (BM) from NSCLC are randomized in a ratio of 1:1 to receive stereotactic radio surgery (SRS) followed by either TTFields or supportive care alone. Patients are followed-up every two months until 2[nd] cerebral progression. Patients in the control arm may cross over to receive TTFields at the time of 2[st] cerebral progression. Key inclusion criteria: Karnofsky performance status (KPS) of 70 or above, 1 inoperable or 2-10 brain lesions amenable to SRS, optimal standard therapy for the extracranial disease, no brain-directed therapy, no signs of significantly increased intracranial pressure, and no electronic implantable devices in the brain. Endpoints: Time to 1[st] cerebral progression based on the RANO-BM Criteria or neurological death (primary); time to neurocognitive failure based on the following tests: HVLT, COWAT and TMT; overall survival; radiological response rate; quality of life; adverse events severity and frequency (secondary). Treatment: Continuous TTFields at 150 kHz for at least 18 hours per day are applied to the brain within 7 days of SRS. The treatment system is a portable medical device allowing normal daily activities. The device delivers TTFields to the brain using 4 Transducer Arrays, which may be covered by a wig or a hat for cosmetic reasons. Patients receive the best standard of care for their systemic disease. Statistical Considerations: This is a prospective, randomized, multicenter study for 270 patients. The sample size was calculated using a log-rank test (based on Lakatos 1988 and 2002) and has 80% power at a two sided alpha of 0.05 to detect a hazard ratio of 0.57.

      Clinical trial identification:

      Legal entity responsible for the study:


      M.P. Mehta: Grants/research support: Novocure; Cellectar (both to institution, not to self) Advisor/board member: Board of Directors of Pharmacyclics Consultant: Cavion, Novocure, Varian, Agenus, Insys, Remedy, IBA Stock shareholder: Pharmacyclics. V. Gondi: Educational honoraria: Novocure Consultant: INSYX Therapeutics. All other authors have declared no conflicts of interest.