Tumour treating fields (TTFields) for the treatment of glioblastoma

Glioblastoma is an aggressive form of brain tumour in adults. The standard treatment for a newly diagnosed glioblastoma consists of surgery, radiotherapy and chemotherapy. There is an additional treatment option in the form of tumour treating fields (TTFields). In Switzerland, the costs of this therapy are reimbursed subject to conditions until the first progression of the tumour. This HTA report examines the efficacy, safety, cost-effectiveness and budgetary impact of TTFields in adults with glioblastoma and analyses the ethical, legal, social and organisational aspects.

The literature research included two randomised controlled trials that investigated treatment with TTFields in two different groups of people: people with newly diagnosed glioblastoma and people with glioblastoma after the activity of the tumour had progressed. It was found that the use of TTFields in newly diagnosed individuals can probably extend the median survival time. In people with progressive tumour activity, treatment with TTFields alone could lead to little or no survival benefit compared with chemotherapy. To evaluate the ethical, legal, social and organisational issues, 16 specialist articles were consulted. The ethical, social, legal and organisational effects include a description of precise adherence to the duration of therapy and social support from the people around the patient.
According to the model, treatment with TTFields for newly diagnosed people costs around CHF 555,000 more per additional year of life with full quality of life than standard treatment. According to the model, reimbursing TTFields could result in healthcare costs of CHF 31 million for newly diagnosed glioblastoma and CHF 49 million over 5 years for recurrent glioblastoma.

The report concludes that the use of TTFields is likely to have a positive effect on survival. At the same time, the therapy results in additional costs in the healthcare system.