TTFields Plus Atezolizumab and Chemotherapy Improves Disease Control in Metastatic Pancreatic Cancer
Key Clinical Summary:
- Design/Population: The phase 2 PANOVA-4 trial evaluated TTFields therapy in combination with atezolizumab and chemotherapy in 78 patients with metastatic pancreatic ductal adenocarcinoma. The primary end point was disease control rate compared with historical controls.
- Key Outcomes: The combination achieved a disease control rate of 74.4%, higher than historical rates observed with chemotherapy alone. Objective response rate was 34.6%, and median overall survival was 9.7 months.
- Clinical Relevance: These findings suggest that TTFields may enhance disease control when added to chemoimmunotherapy in metastatic pancreatic cancer. Randomized trials are needed to confirm efficacy and define its role in clinical practice.
Findings from the phase 2 PANOVA-4 trial demonstrated that first-line treatment with Tumor Treating Fields (TTFields) therapy plus atezolizumab and chemotherapy achieved a higher disease control rate compared with historical control among patients with metastatic pancreatic ductal adenocarcinoma.
In this study, 78 previously untreated patients received 150 kHz of continuous TTFields therapy concomitant with atezolizumab plus gemcitabine and nab-paclitaxel until disease progression or unacceptable toxicity. The primary end point was disease control rate, compared against historical data from the phase 3 MPACT study. Secondary end points included objective response rate (ORR), overall survival (OS), treatment duration, and safety.
At analysis, the disease control rate was 74.4% compared to historical control of 48% (P <.001). The ORR was 34.6% and median OS was 9.7 months. Median duration of TTFields therapy was 25.6 weeks and median duration of systemic therapy was 6 cycles for atezolizumab plus gemcitabine and nab-paclitaxel. Device-related safety was consistent with prior findings.
“The positive results from the PANOVA-4 trial further support the potential of [TTFields] to improve outcomes in pancreatic cancer,” said Uri Weinberg, MD, PhD, Chief Medical and Innovation Officer, Novocure in a press release. “We look forward to evaluating the full results from PANOVA-4 as we advance [TTFields] therapy as a treatment for metastatic pancreatic cancer,” he added.
Sources:
Novocure. Novocure announces positive topline results from phase 2 PANOVA-4 clinical trial of tumor treating fields (TTFields) therapy for metastatic pancreatic cancer. Accessed March 26, 2026. https://www.novocure.com/novocure-announces-positive-topline-results-phase-2-panova-4-clinical-trial-tumor-treating-fields
Clinical Trials. EF-39 PANOVA-4: Study of tumor treating fields concomitant with atezolizumab, gemcitabine and nab-paclitaxel as first-line treatment for metastatic pancreatic ductal adenocarcinoma. Accessed March 26, 2026. https://clinicaltrials.gov/study/NCT06390059
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