Effect of Tumor Treating Fields (TTFields, 150 kHz) as Front-Line Treatment of Locally-advanced Pancreatic Adenocarcinoma Concomitant With Gemcitabine and Nab-paclitaxel (PANOVA-3)
CompletedPhase 3Results postedLast updated 21 January 2026
What this trial tests
Phase 3 trial testing NovoTTF-200T in Pancreas Adenocarcinoma in 571 participants. Completed in 16 October 2024.
Timeline
10 May 2018
Primary endpoint 16 October 2024
16 October 2024
Quick facts
Lead sponsor
NovoCure Ltd.
Phase
Phase 3
Status
Completed
Study type
INTERVENTIONAL
Allocation
randomized
Design
parallel
Masking
none
Primary purpose
treatment
Enrollment
571
Start date
10 May 2018
Primary completion
16 October 2024
Estimated completion
16 October 2024
Sites
199 locations across Hong Kong, Italy, Poland, South Korea, Croatia, Belgium, Mexico, United States
18 and older, any sex, with Pancreas Adenocarcinoma. Patients with the condition only — healthy volunteers not accepted.
Results — posted to ClinicalTrials.gov
Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.
Overall Survival of Subjects Treated With TTFields Concomitant With Gemcitabine and Nab-paclitaxel vs Chemotherapy AlonePrimary· From randomization until death from any cause or last known alive.
Overall survival of subjects treated with TTFields concomitant with gemcitabine and nab-paclitaxel in the first line treatment of unresectable, locally advanced pancreatic cancer subjects, compared to overall survival of subjects treated with chemotherapy alone, measured as the period between the time of randomization and the time of death.
Group
Value
95% CI
TTFields + Standard of Care
16.20
15.01 – 17.97
Standard of Care
14.16
12.81 – 15.44
Progression-free Survival of Subjects Treated With TTFields Concomitant With Gemcitabine and Nab-paclitaxel vs Chemotherapy AloneSecondary· From randomization until radiologic disease progression per RECIST v1.1 or death, whichever occurs first.
Progression-free survival of subjects treated with TTFields concomitant with gemcitabine and nab-paclitaxel in the first line treatment of unresectable, locally advanced pancreatic cancer subjects, compared to the progression-free survival of subjects treated with chemotherapy alone, measured from the time of randomization and based on CT scans collected on the study, using the revised RECIST V1.1 Criteria.
Progression is defined using the RECIST 1.1 criteria: at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study, in addition the sum
Group
Value
95% CI
TTFields + Standard of Care
10.61
9.20 – 12.19
Standard of Care
9.33
7.59 – 11.07
Local Progression-free Survival of Subjects Treated With TTFields Concomitant With Gemcitabine and Nab-paclitaxel vs Chemotherapy AloneSecondary· From randomization until local disease progression per RECIST v1.1 (in the absence of distant metastasis) or death, whichever occurs first.
Local progression-free survival of subjects treated with TTFields concomitant with gemcitabine and nab-paclitaxel in the first line treatment of unresectable, locally advanced pancreatic cancer subjects, compared to the local progression-free survival of subjects treated with chemotherapy alone, measured from the time of randomization and based on CT scans collected on the study, using the revised RECIST V1.1 Criteria.
Local progression is defined per RECIST 1.1 in the absence of distant metastasis: at least a 20% increase in the sum of diameters of target lesions, taking as reference the sma
Group
Value
95% CI
TTFields + Standard of Care
12.45
10.68 – 14.52
Standard of Care
10.41
9.13 – 11.79
Objective Response Rate of Subjects Treated With TTFields Concomitant With Gemcitabine and Nab-paclitaxel vs Chemotherapy AloneSecondary· From randomization until radiologic disease progression per RECIST v1.1 or end of tumor assessment follow-up.
Objective Response Rate (ORR) was assessed per RECIST v1.1. Complete Response (CR): disappearance of all target and non-target lesions and reduction of pathological lymph nodes to \<10 mm. Partial Response (PR): ≥30% decrease in the sum of diameters of target lesions from baseline without new lesions or progression of non-target lesions. ORR is defined as the percentage of participants whose best overall response was CR or PR.
Group
Value
95% CI
TTFields + Standard of Care
88
Standard of Care
73
One-year Survival Rate of Subjects Treated With TTFields Concomitant With Gemcitabine and Nab-paclitaxel vs Chemotherapy AloneSecondary· From randomization through 12 months after randomization.
One-year survival rate of subjects treated with TTFields concomitant with gemcitabine and nab-paclitaxel in the first line treatment of unresectable, locally advanced pancreatic cancer subjects, compared to the 1-year survival rate of subjects treated with chemotherapy alone.
Group
Value
95% CI
TTFields + Standard of Care
68.1
62.0 – 73.5
Standard of Care
60.2
54.2 – 65.7
Quality of Life of Subjects Treated With TTFields Concomitant With Gemcitabine and Nab-paclitaxel vs Chemotherapy AloneSecondary· From randomization until the first ≥10-point deterioration without subsequent improvement, or death, assessed for the duration of study follow-up.
Quality of life deterioration-free survival (DFS) was assessed using the EORTC QLQ-C30 and pancreatic cancer-specific QLQ-PAN26 questionnaires. Higher scores on functional and global health status scales indicate better functioning, whereas higher symptom scores indicate worse symptoms.
DFS was defined as the time from randomization to the first ≥10-point deterioration from baseline without a subsequent ≥10-point improvement, or death. DFS was evaluated separately for each QoL domain included in the analysis.
Global health status / Quality of Life
Group
Value
95% CI
TTFields + Standard of Care
7.1
5.7 – 9.4
Standard of Care
5.7
4.1 – 7.4
Pain (EORTC QLQ-C30)
Group
Value
95% CI
TTFields + Standard of Care
10.1
8.0 – 11.6
Standard of Care
7.4
5.9 – 9.0
Pancreatic pain (EORTC QLQ-PAN26)
Group
Value
95% CI
TTFields + Standard of Care
14.7
12.0 – 16.5
Standard of Care
10.2
8.8 – 12.2
Digestive problems (EORTC QLQ-PAN26)
Group
Value
95% CI
TTFields + Standard of Care
8.3
6.1 – 11.2
Standard of Care
5.7
4.4 – 7.4
Pain-free Survival of Subjects Treated With TTFields Concomitant With Gemcitabine and Nab-paclitaxel vs Chemotherapy AloneSecondary· From randomization until a ≥20-point increase from baseline in pain on the patient-reported visual analogue scale (0-100) or death, whichever occurs first.
Pain-free survival was measured as the duration between the time of randomization until a greater than or equal to twenty-point increase from baseline in a patient self-reported visual analogue scale (VAS) was recorded or death, whichever occurred first.
Group
Value
95% CI
TTFields + Standard of Care
15.18
10.28 – 22.77
Standard of Care
9.13
7.43 – 12.68
Puncture-free Survival of Subjects Treated With TTFields Concomitant With Gemcitabine and Nab-paclitaxel vs Chemotherapy AloneSecondary· From randomization until the first paracentesis or death, whichever occurs first.
Puncture-free survival of subjects treated with TTFields concomitant with gemcitabine and nab-paclitaxel in the first line treatment of unresectable, locally advanced pancreatic cancer subjects, compared to puncture-free survival of subjects treated with chemotherapy alone, measured as the duration between randomization until the first need for paracentesis or death, whichever occurs first.
Group
Value
95% CI
TTFields + Standard of Care
22.8
15.5 – NA
Standard of Care
16.6
13.1 – NA
Resectability Rate of Subjects Treated With TTFields Concomitant With Gemcitabine and Nab-paclitaxel vs Chemotherapy AloneSecondary· From randomization through the end of study follow-up. Surgical resections were captured throughout study follow-up, up to approximately 18 months.
Resectability rate defined as the number and percentage of patients whose tumors were deemed resectable and who underwent surgery.
Group
Value
95% CI
TTFields + Standard of Care
20
4.3 – 10.6
Standard of Care
29
6.9 – 14.2
Adverse events — posted to ClinicalTrials.gov
Time frame: Adverse events were collected from randomization until last study follow up visit and for 30 days following treatment termination, estimated 4 years.
Reporting threshold: 5%.
Adverse-event reports describe events observed during the trial — not all are caused by the drug.
Brief Summary:
The study is a prospective, randomized controlled phase III trial aimed to test the efficacy and safety of Tumor Treating Fields (TTFields) in combination with gemcitabine and nab-paclitaxel, for front line treatment of locally-advanced pancreatic adenocarcinoma.The device is an experimental, portable, battery operated device for chronic administration of alternating electric fields (termed TTFields or TTF) to the region of the malignant tumor, by means of surface, insulated electrode arrays.
Publications & conference data
8 peer-reviewed publications reference this trial (live from Europe PMC):
NCT06558799 — LUNAR-4: Effect of Tumor Treating Fields (TTFields) (150 kHz) Concurrent With Pembrolizumab for Treatment of Metastatic
· Phase 2
· active not recruiting
NCT04892472 — EF-36/Keynote B36: A Pilot, Randomized, Open-label Study of Tumor Treating Fields (TTFields, 150 kHz) Concomitant With P
· Phase 2
· terminated
Other recruiting trials for Pancreas Adenocarcinoma
Currently open trials in the same condition.
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· Phase 2
· recruiting
NCT07262957 — Preventing Postoperative Complications in Patients Undergoing High-risk Pancreatoduodenectomy With a Bundle Approach Inc
· Phase 4
· recruiting
NCT07081360 — Neoadjuvant vs Upfront Surgery for Resectable Pancreatic Cancer and Periampullary Cancer
· Phase 3
· recruiting
NCT07022015 — Predictive Risk Factors for Pancreatic Fistula After Pancreaticoduodenectomy
· NA
· recruiting
NCT06497777 — The Application of DNA Nanomachines for Detecting microRNA in Blood for the Diagnosis of Pancreatic Cancer. Diagnosis of
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Other NovoCure Ltd. trials
Trials by the same sponsor.
NCT06924099 — TTFields General Routine Clinical Care in ndGBM Patients: a French Prospective Non-Interventional Study (TIGER France)
· recruiting
NCT06390059 — EF-39 PANOVA-4: Study of Tumor Treating Fields Concomitant With Atezolizumab, Gemcitabine and Nab-Paclitaxel as First-Li
· Phase 2
· active not recruiting
NCT04717739 — TIGER PRO-Active - Daily Activity, Sleep and Neurocognitive Functioning Study
· unknown
NCT04471844 — Pivotal, Randomized, Open-label Study of Optune® (Tumor Treating Fields) Concomitant With RT & TMZ for the Treatment of
· NA
· completed
NCT04281576 — Effect of Tumor Treating Fields (TTFields, 150 KHz) Concomitant with Chemotherapy As First Line Treatment of Unresectabl
· NA
· completed
Publications: Europe PMC API search by NCT ID, retrieved 10 June 2026
Drug + disease cross-links: matched in real time against Drug Landscape's normalised drug + company + condition tables
Sponsor: as reported to ClinicalTrials.gov by NovoCure Ltd.
Last refreshed: 21 January 2026
Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT03377491.