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A large phase 3 trial found that starting tumor treating fields (TTFields) during chemoradiotherapy — rather than the standard maintenance phase — did not improve survival in newly diagnosed glioblastoma patients. The TRIDENT trial enrolled nearly 1,000 patients and found nearly identical median overall survival between the two timing approaches. Experts caution the results shouldn't be read as undermining TTFields' overall benefit, only its earlier use.
The phase 3 TRIDENT trial, presented at the ASTRO 2026 Annual Meeting, found that initiating tumor treating fields (TTFields) during chemoradiotherapy — rather than waiting until the maintenance phase — offered no meaningful survival advantage for patients with newly diagnosed glioblastoma. TTFields, a wearable device therapy that uses low-intensity electric fields to disrupt cancer cell division, is already FDA-approved for use alongside maintenance temozolomide after chemoradiation.
Experts were quick to clarify that the trial was about timing, not efficacy. "The dangerous misinterpretation is that TTFields in general don't work," said radiation oncologist Praveen Pendyala, MD, of Cleveland Clinic. Notably, patients in the two groups differed in actual TTFields exposure by only about 1.5 months — potentially too small a gap to drive a survival difference.
While the trial doesn't change current practice, an intriguing exploratory signal in MGMT-methylated tumors could open the door to future targeted studies — and the data reinforce that consistent device use remains a key factor in outcomes.
