The effect of field strength on glioblastoma multiforme response in patients treated with the NovoTTFTM-100A system. The last sentence may be the key to a major breakthrough. The Novocure system worked great in the lab - they were able to cure all mice with brain tumors. The initial human gbm trial also came out great. Then the large trial for patients with recurrent gbm didn't come out as good as we hoped for - it was as good or better than any other treatments used, with less side effects, but no major improvement in survival over chemotherapy and/or Avastin. However, the FDA required them to monitor all patients who use the device after it was approved. They reported initial results on all of the hundreds of patients who used the device and the results were better than in the trial. Details will hopefully be released next week.
I think the reason the results improved is experience. The doctors learned how to better aim the electrode placement and realized the importance of high compliance rates. This article brings up what might be the missing key. Theoretically, the device is tuned to kill a range of cell sizes centered on the average size of a gbm cell. This article says that perhaps the device does kill those cells where the field intensity is strong enough, but that if the electrodes are not placed correctly, the edges of the field is not strong enough, and if a gbm cell mutates into a "giant cell" they may be too large to be killed and those cells can repopulate the tumor.
We are hosting a conference in November for researchers working with the device. Hopefully we will see these issues addressed!
