EP12.08 HEALTHCARE PROVIDERS’ EXPERIENCES OF TUMOR TREATING FIELDS (TTFIELDS) FOR GLIOBLASTOMA- A QUALITATIVE STUDY

Abstract BACKGROUND Glioblastoma (GBM) is the most common primary malignant brain tumor in adults and is associated with dismal prognosis. Standard treatment is maximal surgical resection followed by radiation with concomitant and adjuvant chemotherapy with temozolomide. TTFields is nowadays introduced into clinical practice in many countries, after showing that survival is prolonged with 5 months. TTFields allows the unique benefit of tumor treatment outside the hospital setting but also presents a number of specific challenges, where patients need support. In Sweden, TTFields is prescribed by physicians, while the service of equipment and control of its use is provided in the patient’s home by staff from the private company which supplies TTFields. This requires a close collaboration between healthcare providers, the private company and patients, thereby potentially creating conflicts of interest. This study explored healthcare providers’ experiences of TTFields, including views on challenges with the treatment, such as decision making and partnership with the private company providing the device. MATERIAL AND METHODS Healthcare providers involved in the care of patients with GBM were recruited. Semi-structured interviews were performed individually. The interviews were transcribed and analyzed using quantitative content analysis. RESULTS Interviews were completed with 17 physicians and 6 nurses with experience in working within neuro-oncology. The participants had varying opinions regarding the challenges and the magnitude of the practical and ethical problems. A benefit of TTFields is its limited toxicity compared to other treatment options. According to healthcare providers, more patients tolerate wearing the arrays than anticipated. Physically active patients may be more reluctant to using TTFields due to the device´s impact on daily life. Overall, the collaboration with the company providing TTFields is satisfactory, but raises ethical concerns, such as problems with confidentiality, high cost for the therapy and lack of documented agreement regarding collaboration between the company and healthcare providers. The current support system with visiting patients at home by staff from the private company is viewed as inappropriate. Instead, unaffiliated technicians or nurses are suggested for support, to avoid bias. CONCLUSION The introduction of TTFields as a treatment of patients with GBM constitutes a new concept of treating patients in close collaboration with industry. There is a need to search for new solutions for tackling practical and ethical issues. Support: The Medical Research Council of Southeast Sweden (Dnr. FORSS-976715, 981775, 995108) and a grant from the Swedish Brain Tumor Association.