Tumor Treating Fields and quality of life among patients with locally advanced pancreatic adenocarcinoma: secondary analysis of PANOVA-3

The multinational phase 3 PANOVA-3 trial demonstrated survival benefit and tolerability of Tumor Treating Fields (TTFields; 150 kHz) with gemcitabine and nab-paclitaxel compared with gemcitabine and nab-paclitaxel alone among patients with unresectable locally advanced pancreatic adenocarcinoma (LA PAC). Secondary analysis of the trial investigating the impact of addition of TTFields to chemotherapy on quality of life (QOL) and pain has now been published. At baseline, 279 patients in the TTFields plus chemotherapy and 283 patients in the chemotherapy alone arm completed the EORTC QLQ-C30 questionnaire. Digestive symptoms, pain, and pancreatic pain were improved from 2 months after treatment initiation throughout treatment and follow-up in the TTFields plus chemotherapy arm compared with the chemotherapy alone arm. TTFields plus chemotherapy was associated with longer median deterioration-free survival for global health status compared with chemotherapy alone (7.1 months versus 5.7 months; HR 0.77; p=0.02). Longer deterioration-free survival was also observed for most items on the digestive symptoms scales. Median deterioration-free survival was significantly longer with TTFields plus chemotherapy versus chemotherapy alone for pain (10.1 versus 7.4 months; HR 0.70; p=0.003) and pancreatic pain (14.7 versus 10.2 months; HR 0.69; p=0.006) as was median time to opioid use (9.3 versus 6.7 months; HR 0.72; p=0.01). The authors conclude that addition of TTFields to gemcitabine and nab-paclitaxel improved QOL and provided clinically meaningful benefits in pain outcomes among patients with unresectable LA-PAC.