TTFields therapy shows survival benefit in unresectable pancreatic cancer

Tumour Treating Fields (TTFields) therapy has demonstrated a significant survival benefit when used in combination with gemcitabine and nab-paclitaxel as first-line treatment for patients with unresectable locally advanced pancreatic cancer, according to findings from the phase 3 PANOVA-3 trial.

TTFields therapy uses low-intensity, intermediate-frequency alternating electric fields to disrupt cancer cell division and inhibit tumour growth. It is already approved for glioblastoma and mesothelioma and is being studied across multiple solid tumour types. PANOVA-3 (NCT03377491), presented by Dr Vincent Picozzi (Virginia Mason Medical Centre, Seattle, WA, USA), enrolled 571 participants, representing the largest randomised trial to date evaluating TTFields therapy in this setting [1].

Participants with newly diagnosed, locally advanced pancreatic cancer (LA-PAC) were randomly assigned to receive standard chemotherapy: gemcitabine 1,000 mg/m² and nab-paclitaxel 125 mg/m² by intravenous infusion once a day on days 1, 8, and 15 of a 28-day cycle, or the same regimen combined with TTFields. The primary endpoint was overall survival (OS).

The data, simultaneously published in the Journal of Clinical Oncology [2], showed that the addition of TTFields therapy improved median overall survival (OS) by 2 months: 16.2 months versus 14.2 months with chemotherapy alone (HR 0.82; P=0.039).

Pain-free survival, a key measure of patient quality-of-life, was also significantly extended, with a median of 15.2 months in the TTFields group compared with 9.1 months in the control arm (P=0.027). In addition, the 1-year survival rate improved to 68.1% with TTFields, compared with 60.2% in patients receiving chemotherapy alone (P=0.029).

“These results mark a clinically meaningful advance in the treatment of unresectable pancreatic cancer,” said Dr Picozzi. “The addition of TTFields to standard chemotherapy not only extends survival but also significantly improves patients’ quality-of-life by prolonging the period without pain.”

TTFields therapy was well-tolerated in the trial, with no unexpected safety signals reported. Most adverse events were related to the underlying chemotherapy regimen, and skin irritation caused by TTFields was generally manageable.

1. PANOVA-3: Phase 3 study of tumor treating fields (TTFields) with gemcitabine and nab-paclitaxel for locally advanced pancreatic ductal adenocarcinoma (LA-PAC). Abstract LBA4005, ASCO Annual Meeting 2025, 30 May–3 June, Chicago, IL, USA.
2. Babiker HM, et al. J Clin Oncol. 2025;43(15):e123–e134.

Medical writing support was provided by Dr Rachel Giles.
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Posted on 2 June 20252 June 2025