Insight into the public’s interest in tumour treating fields

Access through your institution Buy or subscribe As comprehensively reviewed recently by Rominiyi et al. [1], the use of tumour treating fields (TTF) technology has emerged as a viable

treatment option in both recurrent and newly diagnosed glioblastoma (GBM) [2] as well as in unresectable malignant pleural mesothelioma (MPM) patients [3]. To understand provider patterns in

TTF utilisation, McClelland III et al. [4] surveyed GBM-treating physicians and surgeons in the United States in 2017. Of the 106 respondents, 81% were aware of the inclusion of TTF into

the National Comprehensive Cancer Network (NCCN) guidelines. In contrast, 31% of practices still lacked TTF-certified physicians to offer TTF therapy to GBM patients. Although the study had

a major limitation of low survey response rate, it highlighted an opportunity to better educate and certify oncologists in TTF delivery. Beyond expert practitioners’ adoption rate, public

awareness of this clinically efficacious and well-tolerated antimitotic therapy is currently unknown. As the internet has invariably become the primary source of health information for

patients [5], our group sought to leverage available search engine query data as a proxy to understand whether the emergence of clinical data in support of TTF has translated to

population-level awareness in this novel treatment modality. The publicly available search engine query database, Google Trends [6], was reviewed from January 1, 2007, to January 1, 2021,

with data limited to the United States. English-only search terms queried were generic identifiers, including “alternating electric field therapy” (AEFT) and “TTF”, as well as a known

disease site-specific trade names, “Optune” for GBM and “Optune Lua” for MPM. Relative monthly search volume index (MSVI) was extracted from the database, with monthly search frequency

represented by a scale ranging from a value of 100, denoting the highest monthly search frequency for the specific term to 0 or lowest monthly frequency. For context, relative MSVI of TTF

terms were then compared to MSVI generated from baseline terms, “glioblastoma” and “mesothelioma”, over the same period. Student’s _t_ test was used to quantify differences in MSVI averages

between periods of interest. To account for the likely non-linear relationship between trends in MSVI versus time, polynomial regression analysis was employed. This is a preview of

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ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support DATA AVAILABILITY Data are accessible through Google Trends

(http://www.google.com/trends). REFERENCES * Rominiyi O, Vanderlinden A, Clenton SJ, Bridgewater C, Al-Tamimi Y, Collis SJ. Tumour treating fields therapy for glioblastoma: current advances

and future directions. Br J Cancer. 2021;124:697–709. Article  Google Scholar  * Stupp R, Taillibert S, Kanner AA, Kesari S, Steinberg DM, Toms SA, et al. Maintenance therapy with

tumor-treating fields plus temozolomide vs temozolomide alone for glioblastoma: a randomized clinical trial. JAMA. 2015;314:2535–43. Article  CAS  Google Scholar  * Ceresoli GL, Aerts JG,

Dziadziuszko R, Ramlau R, Cedres S, van Meerbeeck JP, et al. Tumour treating fields in combination with pemetrexed and cisplatin or carboplatin as first-line treatment for unresectable

malignant pleural mesothelioma (STELLAR): a multicentre, single-arm phase 2 trial. Lancet Oncol. 2019;20:1702–9. Article  CAS  Google Scholar  * McClelland S 3rd, Sosanya O, Mitin T, Degnin

C, Chen Y, Attia A, et al. Application of tumor treating fields for newly diagnosed glioblastoma: understanding of nationwide practice patterns. J Neurooncol. 2018;140:155–8. Article  CAS 

Google Scholar  * Hesse BW, Nelson DE, Kreps GL, Croyle RT, Arora NK, Rimer BK, et al. Trust and sources of health information: the impact of the Internet and its implications for health

care providers: findings from the first Health Information National Trends Survey. Arch Intern Med. 2015;165:2618–24. Article  Google Scholar  * Google, Inc. Google Trends. 2021.

http://www.google.com/trends. Accessed 15 March 2021. * Nuti SV, Wayda B, Ranasinghe I, Wang S, Dreyer RP, Chen SI, et al. The use of google trends in health care research: a systematic

review. PLoS ONE. 2014;9:e109583. Article  Google Scholar  Download references FUNDING No funding was received to assist with the preparation of this manuscript. AUTHOR INFORMATION AUTHORS

AND AFFILIATIONS * Department of Radiation Oncology, NYU Grossman School of Medicine, New York, NY, USA David J. Byun, Aram S. Modrek & Erik P. Sulman * Brain and Spine Tumor Center,

Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA Erik P. Sulman Authors * David J. Byun View author publications You can also search for this author inPubMed 

Google Scholar * Aram S. Modrek View author publications You can also search for this author inPubMed Google Scholar * Erik P. Sulman View author publications You can also search for this

author inPubMed Google Scholar CONTRIBUTIONS D.J.B., A.S.M. and E.P.S. contributed equally to conception, interpretation of data, and preparation of this manuscript. D.J.B. contributed to

analysis of the data. All authors read and approved the final manuscript. CORRESPONDING AUTHOR Correspondence to David J. Byun. ETHICS DECLARATIONS ETHICS APPROVAL AND CONSENT TO PARTICIPATE

Not applicable. CONSENT TO PUBLISH Not applicable. COMPETING INTERESTS D.J.B. and A.S.M. have no conflicts of interest to report. E.P.S. has received research support and honoraria from

Novocure Ltd. ADDITIONAL INFORMATION PUBLISHER’S NOTE Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. RIGHTS AND

PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Byun, D.J., Modrek, A.S. & Sulman, E.P. Insight into the public’s interest in tumour treating fields. _Br J

Cancer_ 125, 901–903 (2021). https://doi.org/10.1038/s41416-021-01504-9 Download citation * Received: 08 June 2021 * Revised: 28 June 2021 * Accepted: 19 July 2021 * Published: 27 July 2021

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