Tumor Treating Fields plus chemo shows OS benefit in unresectable pancreatic cancer

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Published: 1 Jun 2025
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Dr Vincent Picozzi - Virginia Mason Medical Center, Seattle, USA

Dr Picozzi talks to ecancer about data from the phase 3 PANOVA-3 trial he presented at ASCO 2025.

The results demonstrated that adding tumor treating fields (TTFields) therapy to gemcitabine and nab-paclitaxel improved overall survival and pain-free survival in patients with locally advanced pancreatic adenocarcinoma (LA-PAC), without increasing systemic toxicity.

He notes that these results mark the first phase 3 evidence of a survival benefit in LA-PAC, positioning TTFields as a promising new treatment option, supported by favourable safety and enhanced distant progression-free survival outcomes.

The study at ASCO is entitled the PANOVA-3 trial and what this is is an examination of the use of tumour treating fields in locally advanced pancreatic cancer.

What was the study design?

The study design was a randomisation between the chemotherapy gemcitabine and nab-paclitaxel with and without the use of the tumour treating fields. It was a randomised non-blinded comparison of that treatment regiment with and without the device that produces the tumour treating fields.

What were the results of this study?

Happily there was a positive result to the investigational arm and proudly I can say this is the first positive trial ever in a randomised fashion looking at advanced pancreas cancer. The use of the tumour treating fields did add approximately two months in overall survivorship to the use of chemotherapy by itself. There were also other positive findings, including a reduction in the progression of pain.

What is the significance of these results?

I believe these results establish a new standard therapy for pancreatic cancer in that by showing an improvement in survival, not only does this indicate a potential for use of this device in this treatment setting but I think it also provides a platform for further study in pancreatic cancer and even other tumours, both in earlier stage and later stage disease.

One of the interesting things about the trial is that it also showed an improvement in distant disease-free progression, so not just the primary cancer itself but progression to metastases elsewhere which implies a systemic effect, potentially an immunological effect. So it opens the door to use not just in localised pancreas cancer but metastatic disease.

Please elaborate more on the device used in this study.

The device is about 3lbs in size. It’s about the size of a book and people typically are wearing a pack that they’re given. The device is attached to the person by some wires which are then placed using an array that adheres to the surface of the skin on the abdomen. As the study was originally designed, there were actually four such arrays or paddles – one front, one back and two on the sides. So through that the alternating electrical fields are passed through the patient’s abdomen, focussing on the pancreas cancer. People were asked as a target to wear the device 18 hours a day.

Is there anything else you would like to add?

I would want to emphasise that the device was actually very save to use. The vast majority of people were able to use it. The incremental side effect of skin toxicity was, in general, well managed.

So the points are it prolongs survivorship, it improved quality of life and it was also safe and practical to use.