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I have been saying this for years. I am a big fan of Optune, but by itself (or even with Temodar), it is not enough. It will improve survival by a few months (longer than any other approved treatments), and a small % of patient will go on to become long term survivors, but we can do so much better. This article explains how Optune could be used in a cocktail approach to bring us closer to the cure. I love to see so much research, but the pace is too slow for me. They talk about possible mechanisms of resistance to Optune and ways around it. This is the research we need.
They talk about clinical trials. One of my favorite theoretic combinations is Optune + Choraquine. Many years ago there was a presentation about resistance to Optune, and autophagy was mentioned as a main resistance pathway. Chloraquine may inhibit autophagy, which may make Optune work better. This was finally formalized into a clinical trial which was posted on Clinicaltrials.gov May 21, 2020. Almost a year ago - but it is still listed as "not yet recruiting". The timeline of having an idea, creating a clinical trials, running the trial, then getting results published and made useful to people is about 5-10 years. We do not have that much time, as we need many iterations of the process to get to the cure. And here we are talking about approved treatments (and off label treatments) that are relatively easy to get access to. Trying it with experimental treatments would be much harder and take much longer.
My solution to this is a program like our patient navigation program, where a team of experts (now including 3 neuro-oncologists, a few PhD researchers, nurse navigators and our artificial intelligence system) reviews patient records and comes up with what they feel is the best treatment plan options. The patient and their health care team can pick one of the options we present, or do whatever else they want. The key is that we then track their case as if in a clinical trial, and learn from every patient. We can create virtual trials of combinations like that mentioned above. Try them on a set number of people then analyze the outcomes. Improve with each new iteration. This is actually working now, and we have it listed on clinicaltrials.gov as A Patient-Centric Platform Trial for Precision Oncology. We just need a lot more patients to participate to speed up the learning process! To join, go to https://virtualtrials.org/xcelsior.cfm