Al's Comment:

 This gives an excellent review of Optune with an explanation of how it works, how it might be combined with other treatments to improve outcomes, and basically says it should be part of the standard of care. I agree completely.  The arguments against using Optune are discussed and put into perspective. For example, the biggest argument against was that the clinical trials did not use a "placebo" device for the control group.  I agree with the authors when they say it is unethical to make a brain tumor patient shave their head and wear an uncomfortable device around without the chance of benefit.  I would not refer patients to a clinical trial using such a placebo device control.  They also argue that the Optune group used Temozolomide longer than the control group.  Duh. The progression free period was longer in the Optune group and both groups stopped Temozolomide when progression occurred.  They go on to discuss costs. It is an expensive treatment, and in Europe it might not have the cost / benefit ratio to allow the countries to pay for it but in the USA where life is valued higher, it is worth it.  The authors do not mention it but the cost of other treatments being used which had much less benefit are way higher. Bottom line: I feel Optune should be part of the standard of care for newly diagnosed Glioblastoma.  Possibly also  for recurrent Glioblastoma but only if it is combined with something else.

Posted on: 07/26/2021

Tumor-Treating Fields for the treatment of glioblastoma: a systematic review and meta-analysis


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