case_images: PMC11324212_01
case_images: a, b CT scans of the patient's abdomen at initial diagnosis (November 2011) with arrows indicating 4-cm and 3-cm masses in the hepatic segment VIII. c-f CT scans of the patient following disease progression after nivolumab treatment for 51 months (September 2019). c Arrow indicates the 10-mm lesion in the hepatic segment V. d Arrow indicates the 16-mm lesion in the mesenteric node. e, f Arrows indicate the 10-mm and 7-mm lesions in hepatic segment VI. Models courtesy of Novocure Ltd, Haifa, Israel.
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case_images: PMC11324212_01_cro-2024-0017-0001-539719_F01.jpg
case_images: F1
case_images: A full timeline of the patient's journey can be seen in online supplementary Figure 1. The tumor was reported as a hepatic adenoma, so the patient continued normal follow-up until November 2011 when a computed tomography (CT) scan showed 4-cm and 3-cm masses in hepatic segment VIII (Fig. 1a, b). In September 2019, a routine CT scan confirmed disease progression with the development of 1 lesion (10 mm) in hepatic segment V, 2 new hepatic lesions (10 mm and 7 mm) in hepatic segment VI, and 1 lesion (16 mm) in the mesenteric node (Fig. 1c-f).
case_images: a Patient-specific simulations for transducer array placement - arrays are paired in the anteroposterior (AP) and lateral (LR) directions, with the field active in each direction alternatively every 1 s. b Array placement relative to the tumor (in blue). c Axial slices of field intensity maps in both the AP and LR directions, with the tumor marked up in white (white arrow).
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case_images: F2
case_images: A patient-specific model was segmented using the patient's CT scan, and virtual transducer arrays were placed on the model based on the prescribed array layout (Fig. 2a, b). Resulting average TTFields intensity delivered to the tumor was 2.36 V/cm peak to peak (2.52 V/cm in the anteroposterior direction and 2.18 V/cm in the lateral direction [Fig. 2c]).
case_images: a-c CT scans of the patient demonstrating stable disease after 1 year of TTFields therapy concomitant with sorafenib (January 2020); arrows indicate lesions. d Bar chart depicting rates of TTFields therapy usage throughout the treatment period - the red line indicates the minimum advised time as per label recommendations in approved indications, GBM and mesothelioma. e Color-coded chart stratifying low usage (50-60%), medium usage (75-85%), and high usage (>=85%) throughout the treatment period. TTFields, Tumor Treating Fields.
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case_images: F3
case_images: At the first evaluation in January 2020, the CT scan showed partial response with minimal residual disease (Fig. 3a-c). TTFields therapy for over 39 months. Mean TTFields therapy usage was 87%, with an average daily time on treatment of 21 h (Fig. 3d, e). The TTFields therapy usage was assessed as recommended by the sponsor.