Tumor Treating Fields Therapy After Platinum-Based Chemotherapy in Advanced Non-Small Cell Lung Cancer: A Single-Institution Real-World Analysis

Background/Objectives: The LUNAR trial demonstrated the benefit of Tumor Treating Fields (TTFields) therapy in patients with metastatic NSCLC (mNSCLC) after platinum-based chemotherapy. However, real-world outcomes in patients treated with contemporary systemic regimens have yet to be empirically demonstrated. Methods: In this retrospective single-institution study, patients with mNSCLC treated with TTFields (150 kHz) after platinum-based chemotherapy between 2018 and 2026 were included. Progression-free survival (PFS) and overall survival (OS) were estimated from TTFields therapy initiation using the Kaplan–Meier method. Results: Sixteen patients were included. The median age was 73 years, 63% were male, 69% had adenocarcinoma histology, and 69% were PD-L1 positive. At TTFields therapy initiation, 94% had ECOG performance status ≤ 2, 19% had brain metastases, 31% had liver metastases, and 94% had prior ICI exposure. Median PFS was 11.8 months, and median OS was 19.9 months. OS did not differ significantly between the ICI-based and docetaxel-based groups (not reached vs. 13.5 months; p = 0.60) but PFS was shorter (3.9 months vs. not reached; p = 0.046). Treatment-related dermatitis was limited to grade 1–2 events, and no grade 3 or higher device-related toxicities were observed. Conclusions: TTFields therapy demonstrated encouraging real-world OS outcomes and favorable tolerability in this first report of a contemporary post-platinum NSCLC population, supporting further prospective evaluation of optimal timing and integration with modern systemic therapies.