A qualitative evaluation of factors influencing Tumor Treating fields (TTFields) therapy decision making among brain tumor patients and physicians.

BACKGROUND: Tumor Treating Fields (TTFields) Therapy is an FDA-approved therapy in the first line and recurrent setting for glioblastoma. Despite Phase 3 evidence showing improved survival with TTFields, it is not uniformly utilized. We aimed to examine patient and clinician views of TTFields and factors shaping utilization of TTFields through a unique research partnership with medical neuro oncology and medical social sciences. METHODS: Adult glioblastoma patients who were offered TTFields at a tertiary care academic hospital were invited to participate in a semi-structured interview about their decision to use or not use TTFields. Clinicians who prescribe TTFields were invited to participate in a semi-structured interview about TTFields. RESULTS: Interviews were completed with 40 patients with a mean age of 53 years; 92.5% were white and 60% were male. Participants who decided against TTFields stated that head shaving, appearing sick, and inconvenience of wearing/carrying the device most influenced their decision. The most influential factors for use of TTFields were the efficacy of the device and their clinician's opinion. Clinicians (N = 9) stated that TTFields was a good option for glioblastoma patients, but some noted that their patients should consider the burdens and benefits of TTFields as it may not be the desired choice for all patients. CONCLUSIONS: This is the first study to examine patient decision making for TTFields. Findings suggest that clinician support and efficacy data are among the key decision-making factors. Properly understanding the path to patients' decision making is crucial in optimizing the use of TTFields and other therapeutic decisions for glioblastoma patients.

Rationale and Background on Tumor-Treating Fields for Glioblastoma.

BACKGROUND: More than 150 years after the first description of glioma cells, patients with glioblastoma (GBM) continue to have a poor prognosis despite standard-of-care therapy. With the introduction of tumor-treating fields (TTFields) therapy for the treatment of recurrent GBM in 2011 and for newly diagnosed GBM in 2015, the opportunity to increase progression-free survival and overall survival while improving quality of life provides a welcome option. OBJECTIVES: This article describes how TTFields therapy may be used in the treatment of patients with recurrent GBM. METHODS: This article provides oncology nurses with two case studies that examine how TTFields therapy can be integrated into the overall treatment paradigm. FINDINGS: These two patient case studies demonstrate the autonomy and lack of adverse effects that TTFields therapy offers to patients with GBM.