Advances in tumor treating fields for solid tumors: Mechanism, evidence and future outlook

BACKGROUND: Tumor Treating Fields (TTFields) is a novel, non-invasive anti-tumor modality using low-intensity alternating electric fields to disrupt cancer cells. Initially approved for glioblastoma, TTFields is now under investigation in multiple solid tumors. OBJECTIVES: We synthesized evidence from preclinical and clinical studies, with the aim to emphasize TTFields' mechanistic insights and outcomes in various solid tumors. METHODS: We performed a comprehensive search and included original articles, review articles, case reports/series, meeting abstracts/reports and clinical trials that were published, completed or conducted between January 1, 2000 and August 31, 2025. All papers reviewed and their key references were cross-checked to ensure a balanced and high-quality literature review on the subject. RESULTS: Our retrieved in vitro and in vivo preclinical studies indicated that TTFields could inhibit tumor growth by interfering with mitosis, disrupting deoxyribonucleic acid (DNA) replication and repair, inducing apoptosis, activating autophagy, modulating immune response, suppressing metastasis and influencing cellular membrane permeability. Clinical studies further demonstrated it to be safe and efficacious in multiple solid tumors, with evidence of synergistic effects in combination with other anti-tumor therapies. CONCLUSIONS: TTFields introduces an innovative dimension to solid tumor treatment. Its advantages, including non-invasive anti-tumor effects, minimal systemic toxicity and superior therapeutic benefit in combination with diversified anti-tumor therapies, have been confirmed by results from preclinical and clinical studies. In the future, further exploration is needed in indication expansion, new therapeutic combinations, biomarker identification and device renovation in the pursuit of better solid tumor management.