DISP-34. Disparities in Tumor Treating Fields (TTFields) Awareness, Access, and Patient Experience: Findings from a National GBM Survey

Abstract Tumor Treating Fields (TTFields) are an FDA-approved component of guideline-concordant care for glioblastoma (GBM), yet patient access remains inconsistent across the United States. Informed by the GBM Bill of Rights and building on findings presented at the 2024 SNO Annual Meeting, we conducted a national survey investigating disparities in TTFields awareness, access, treatment timing, and satisfaction with care. A 36-item HIPAA-compliant survey was developed by OurBrainBank, a patient-led GBM nonprofit, and fielded via Survey Healthcare Global from February to September 2024. Respondents included GBM patients, current caregivers, and bereaved caregivers. Chi-square tests and linear regression assessed associations between social determinants of health and TTFields-related outcomes. Among 525 respondents (77% caregivers; 23% patients), the median age at diagnosis was 59; 55% had a college degree, 66% held private insurance, and 49% received care at an NCI-designated cancer center. Age-related disparities in TTFields access were evident, with younger patients significantly more likely to report being offered TTFields (p = 0.009). Timing of access varied by site and gender; patients at NCI centers and male patients were more likely to be offered TTFields as part of first-line treatment (p = 0.026 and p = 0.039, respectively). Patients with higher UCLA 3-item loneliness scores were more likely to report TTFields access or use challenges (p = 0.016), though this relationship may be indirect. More generally, we found that respondents with higher loneliness scores were significantly associated with lower satisfaction with oncologist care (1-10 scale; p = 0.002), highlighting a broader psychosocial disparity. Overall, 40% of respondents reported dissatisfaction with care from their oncologist (score ≤7) and were invited to provide qualitative feedback. In their responses, many participants voiced frustration around treatment options, with several explicitly referencing TTFields access, including delayed discussions about TTFields, inadequate information, and the burden of having to self-advocate to initiate conversations about its use. These findings highlight how sociodemographic and psychosocial factors can influence access to and experience with TTFields.