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MO_10_2709 - Nationwide Characteristics of Providers Utilizing Tumor Treating Fields for Newly Diagnosed Glioblastoma

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Nationwide Characteristics of Providers Utilizing Tumor Treating Fields for Newly Diagnosed Glioblastoma
S. McClelland III1, O. Sosanya1, T. Mitin2, C. Degnin2, Y. Chen2, A. Attia3, J. H. Suh4, and J. J. Jaboin2; 1Department of Radiation Medicine, Oregon Health & Science University, Portland, OR, 2Oregon Health and Science University, Portland, OR, 3Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN, 4Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH

Purpose/Objective(s): Tumor treating fields (TTF) harnesses magnetic fields to induce apoptosis in targeted regions. Completion of a recent randomized phase III trial of newly diagnosed glioblastoma (GBM) patients revealed TTF + temozolomide to be superior to temozolomide alone, increasing overall survival by 4.9 months and lifespan by more than 30% (Stupp et al., JAMA 2017). We sought to examine characteristics of providers utilizing TTF for GBM in the United States (US).

Materials/Methods: A survey was electronically administered to US practices self-identifying as specializing in radiation oncology, medical oncology, neuro-oncology, neurosurgery, and/or neurology. Responses were collected anonymously; the survey was constructed to assess responder knowledge of appropriate clinical scenarios for TTF, knowledge of TTF therapy status on National Comprehensive Cancer Network (NCCN) guidelines, as well as additional demographic data. Based on responses, participants were categorized as “users” or “nonusers” of TTF for newly diagnosed GBM. Utilization of TTF was correlated with practice patterns using Fisher’s exact test.

Results: Of the 106 responders, 69% were in practices offering TTF for newly diagnosed GBM. Users of TTF were more likely to have greater high-grade glioma volume (>10 GBM patients/year; p=0.024; relative risk = 1.5), be knowledgeable of TTF inclusion on the 2016 National Comprehensive Cancer Network (NCCN) guidelines (p<0.0001; odds ratio = 10.4; relative risk = 3.0), and specialize in radiation oncology or neuro-oncology (p=0.016). There was no difference in years of practice, location of training, geographic location of practice, number of physician-partners in immediate practice, or academic versus private practice setting between users and nonusers of TTF.

Conclusion: TTF for newly diagnosed GBM in the US is administered by providers who are knowledgeable of its inclusion in the 2016 NCCN guidelines, have elevated high-grade glioma volume, and specialize in radiation oncology or neuro-oncology. Knowledge of TTF inclusion in the 2016 NCCN guidelines roughly tripled the likelihood of TTF utilization for newly diagnosed GBM, and practices with GBM volume of at least 10 patients/year increased the likelihood of TTF utilization by roughly 50 percent. Providers seeking to refer newly diagnosed GBM patients for TTF should seek out practices with several of these characteristics to ensure optimal TTF access for their patients.

Author Disclosure: S. McClelland: None. O. Sosanya: None. T. Mitin: Honoraria; UpToDate Inc. C. Degnin: None. Y. Chen: None. A. Attia: Employee; Vanderbilt University. Honoraria; Brainlab, qfix. Advisory Board; AstraZeneca. Travel Expenses; qfix. Director of Radiosurgery Program; Vanderbilt University. Nashville Volunteer Leadership Board Member; American Cancer Society. J.H. Suh: Consultant; ACMUI, Chrisalis BioTherapeutics. Board member; Korean American Society for Therapeutic Radiation. J.J. Jaboin: None.

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