Tumor treating fields (Optune®)

An electromagnetic field therapy that uses alternating electrical fields to disrupt mitosis (i.e., cell division); cellular proteins are prevented from moving to their correct locations, resulting in cancer cell death. This therapy, also known as tumor treating fields (TTFs), externally delivers alternating electric fields that are very-low intensity and of intermediate frequency (i.e., 100-300 kHz) to an area of proliferating cancer cells.

Tumor treating fields (TTF) was first reviewed by the HTA program in 2016.

In 2017, an update literature search was conducted on TTF to determine if newly available evidence published since the 2016 assessment could change the original coverage determination.
In 2018, the HCA director selected tumor treating fields for rereview based on newly available published evidence.

Status: Decision completed

View findings and decision

Why is TTF being reviewed?

Optune® (formerly the NovoTTF-100A System or Novocure), a delivery system for tumor treating fields (TTFs), was approved by the U.S. Food and Drug Administration (FDA) in 2011 for the treatment of recurrent glioblastoma multiforme (GBM) and in 2015 for the treatment of newly diagnosed GBM in combination with temozolomide, an oral chemotherapy drug. The Health Technology Clinical Committee (HTCC) voted in January 2016 to not cover Optune®. The 2018 health technology assessment (HTA) reviews the efficacy, safety, and cost-effectiveness of TTFs for treating GBM and other cancers to assist the HTCC in reviewing its existing policy and determining coverage for this medical device.

Primary criteria ranking

Safety = Low
Efficacy = High
Cost = High

Documentation

Type	Materials
Assessment (2018)	Final key questions Draft report: response to peer review and public comment Final evidence report Final findings and decision
Update literature (2018)	Evidence update literature (2018)
Assessment (2016)	Draft key questions: comment and response Final key questions Updated final evidence report Final findings and decision

Assessment timeline

Draft key questions published: May 31, 2018
- Public comment period: June 1 to June 14, 2018
Final key questions published: June 22, 2018
Draft report published: August 31, 2018
- Public comment period: August 31, to October 1, 2018
Final report published: October 17, 2018
HTCC public meeting: November 16, 2018