TTFields Show Significant Survival Benefit in Pancreatic Cancer

Vincent Picozzi, MD, medical oncologist and director of the Pancreaticobiliary Program, Virginia Mason, discusses findings from the randomized phase 3 trial PANOVA-3 (NCT03377491) of tumor treating fields (TTFields) with gemcitabine and nab-paclitaxel for the treatment of patients with locally advanced pancreatic cancer.

According to data presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting and published in the Journal of Clinical Oncology, patients who received TTFields experienced an 18% improvement in overall survival (OS) vs chemotherapy alone (HR, 0.82; 95% CI, 0.68-0.99; P =.039), as well as benefits in quality of life and pain-free survival. Skin toxicity associated with TTFields was reported, but it was generally low-grade.

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0:10 | This becomes a new standard of care that one can consider because the survival results were statistically superior. So, if there is a patient with this disease in which the oncologist is using gemcitabine and nab-paclitaxel, the addition of the tumor-treating fields device can produce superior results in terms of overall survival.

0:31 | I think it also provides a platform for additional research in pancreatic cancer, both in cancers that are localized to the pancreas and metastatic. One of the surprising findings of the trial is that the biggest therapeutic benefit was not seen in the primary pancreas cancer itself, what we call local progression, but in the emergence of cancer elsewhere in the body, what we call distal or systemic progression. So interestingly, the device seemed to have a bigger impact on cancer cells that you could not see away from the pancreas than the pancreas itself.

1:01 | And that is producing a lot of interesting speculation as to how the device really works and what it can accomplish. But it opens up possibilities for using it in patients, even with metastatic disease. In fact, the company has a trial called the PANOVA-4 trial [NCT06390059], which looks at gemcitabine and nab-paclitaxel with the device and also with pembrolizumab [Keytruda] to augment immune response.