Tuesday, 1 March 2016

New Information on NovoCure TTFields in Combination with Immunotherapy

Hello all,

NovoCure went public  this past year, which increases the transparency in the company.  The following is from the conference call that they had with investors today, but provides information that I have never seen addressed with regards to NovoCure:

Okay, that's helpful. Lastly for me, so a bit of a long-winded question so please bear with me. But obviously Celldex has their second interim analysis for RINTEGA in March, and their product addresses about 25% to 30% of GBM patients.
And some docs we've spoken with have indicated they might not use Optune on top of RINTEGA because of added cost, the burden to the patient, and some uncertainty around whether Optune is additive. So how do you plan to ensure that a positive outcome for RINTEGA does not negatively impact adoption of Optune? Thanks for taking all my questions, guys.

I'm going to turn this one over to Eilon Kirson, but clearly, immunotherapy is a topic of interest, with respect to the specifics of Celldex, but also more broadly. We've demonstrated, over time, how well Optune works with chemotherapy, anti-angiogenic therapies, and of course we are focused on immunotherapy as well. Eilon, why don't you provide a little bit of an update with respect to our work in this area?

So this is actually a little bit of new information which we haven't shared before. As we've promised in previous meetings and have committed to looking at the effect of Tumor Treating Fields together with immune therapies, we have actually started a large project in pre-clinical research looking at combination of Tumor Treating Fields with immune therapies, and specifically we looked at PD1 inhibitors.
And we have some very interesting initial findings, showing first of all that Tumor Treating Fields do not adversely affect the immune cell infiltration into the tumor. So this potentially allows for a full immune response to be mounted against tumor cells using immune therapy in the presence of Tumor Treating Fields.
In addition to that, there is work that was presented from Tel Aviv Medical Center, where they applied Tumor Treating Fields to immune cells, to specifically CD4 cells, and looked at the functionality of these cells. And they found that there was no decrease in several of the major immune activity parameters, including secretion of anti-tumeral molecules, increased PD1 expression and exhaustion on the immune cells, and active degranulation. So all of these immune parameters are maintained in the presence of Tumor Treating Fields.
Finally, we looked at combination of Tumor Treating Fields together with specifically PD1 inhibitors in animal models. And so that tumor volumes were lower for the combination treatments of TTFields with PD1 inhibitors, significantly lower than either treatment alone.
So we feel a lot more comfortable today saying that what we've said before without the data just as a belief. But today, I think we have data to support the fact that Tumor Treating Fields will be able to used together with immune therapy, and that should actually I think make it much easier for prescribers when this data is published and presented. It will make it much easier for users to use TTFields together with immune therapies if they're approved.

It seems as though their preclinical animal models are showing a benefit when NovoCure is combined with immunotherapy.  Let's hope this continues to play out in humans.


  1. Kendall, thanks for posting this information, very helpful. In addition to TTFields, radiation therapy combined with these immunotherapy drugs is promising for similar reasons. Additionally, combining vaccine treatment with the PD-1 inhibitors or trying the PD-1 inhibitors after vaccine therapy is a good approach.

  2. Thanks for sharing this Kendall. You may recall there was a presentation at SNO 2014 in Miami, showing that TTFields was also found to promote immunogenic cell death, ie a form of tumor cell death that promotes anti-tumor immune responses.

  3. Thank you for posting this question/answer Kendall.

  4. My english is not that good, but do you mean that TTfields can kill the immune system and promote cancer ?

    1. "Immunogenic cell death" means that TTFields are killing cancer cells in such a way that alerts the immune system to the cancer, which further strengthens the beneficial effects of TTFields.