According to an analysis of the PANOVA-3 trial, the addition of tumor treating fields (TTFields) to gemcitabine/nab-paclitaxel showed a statistically significant and clinically meaningful improvement in pain and quality of life among patients with locally advanced pancreatic adenocarcinoma.

These data were first presented by Teresa Macarulla Mercade, MD, Vall d’Hebron University Hospital, Barcelona, Spain, at the 2025 European Society for Medical Oncology (ESMO) Gastrointestinal Cancers Annual Congress in Barcelona, Spain.

In this phase 3 trial, patient with locally advanced pancreatic adenocarcinoma were randomized to receive gemcitabine/nab-paclitaxel either alone or with the addition of TTFields. It has been previously reported that the addition of TTFields showed a statistically significant improvement to overall survival and pain-free survival, compared to gemcitabine/nab-paclitaxel alone. The impact of TTFields on quality of life, pancreatic cancer symptoms and use of pain medications were evaluated. 

The time to deterioration of pain (P = .003) and pancreatic pain (P = .006) were significantly longer among patients treated with TTFields — scores increased by 2 months of treatment and were maintained to 26 months. Time to deterioration in global health status was also significantly longer among patients treated with TTFields (P = .023). There was no difference in insomnia and fatigue. The time to meaningful pain medication (P = .049) and time to opioid use (P = .046) were both significantly longer with TTFields. Aside from indigestion, all digestive issue scales were significantly favored in the TTFields arm. 

Study authors concluded “TTFields with [gemcitabine/nab-paclitaxel] shows statistically and clinically significant and meaningful improvements in pain and [quality of life]” among patients with locally advanced pancreatic cancer. They added that these data “complement the OS benefit seen in PANOVA-3” and support “TTFields and [gemcitabine/nab-paclitaxel] as a new therapeutic option] for this patient population.

Source:

Macarulla Mercade T, Picozzi VJ, Chandana S, et al. PANOVA-3: Pain and quality of life (QoL) outcomes with tumor treatment fields (TTFields) therapy in patients with locally advanced pancreatic adenocarcinoma (LAPC). Presented at 2025 ESMO GI Cancers Annual Congress. July 2-5, 2025; Barcelona, Spain. Abstract: LBA3