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One exciting result from his studies, says Palti, is that there is “excellent synergy between electric-field treatment and chemotherapy.” In an unpublished lab study of several types of cancer, he says, adding electric-field treatment makes several chemotherapeutics more effective at lower doses. NovoCure is now conducting a pilot trial in Europe in which patients begin electric-field treatment in conjunction with chemotherapy when they are first diagnosed with glioblastoma. The results are preliminary, but, Palti says, “I strongly believe that the combination treatment will … enable one to reduce the chemo doses to levels where their side effects will be significantly reduced.”

Palti says that after more than 200 cumulative months of electric-field treatment in several patients, there have been no side effects beyond irritation of the scalp. “So far, toxicity seems to be low,” says Engelhard. This stands in stark contrast to chemotherapy and radiation, which cause many side effects, including nausea, hair loss, and fatigue.

One worry is that the electric-field treatment could affect healthy cells that are dividing. The electric fields emerging from the electrodes can’t be focused, says Cohen, and although they are primarily concentrated in the brain in the glioblastoma trial, they may also reach other parts of the body where cells are dividing. Cells in the bone marrow, for example, multiply at a great rate to create red blood cells and immune cells. But Palti says that the electric fields have no effect on blood-cell counts. The bone and muscle surrounding the marrow appear to protect the cells..

It’s unclear how long patients will need to wear the device. “We’re hesitant to stop treatment, because the consequences could be severe,” says Palti, although one patient whose cancer has disappeared has stopped wearing the device. Patients must go to the clinic twice a week to have their heads shaved so that their hair doesn’t interrupt contact between the scalp and the electrodes. The device itself costs only about $1,000 to manufacture, but replacing the electrodes twice a week is expensive.

Engelhard says that he got involved with the NovoCure clinical trial because the electric-field treatment is “radically different” from all existing cancer treatments. For patients with recurrent glioblastoma and other deadly forms of cancer, there are few options. “Researching and testing new therapies for this type of patient is very important,” says Engelhard.

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Credit: Yoram Palti, NovoCure (top image); Proceedings of the National Academy of Sciences (bottom MRIs)

Tagged: Biomedicine, cancer, brain, Israel, electric fields

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