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This is a complicated study to read. The shocking data to me is in the supplemental materials. These show how few patients - especially the elderly - get the standard Temodar regimen. Over half of MGMT unmethylated patients do not even get Temodar at all. Only 26% of MGMT methylated patients complete the standard schedule of Temodar and 35% do not even get any Temodar. They did note that if you do complete the entire course of Temodar (which they say is 6 weeks during radiation then 6 months after), you have a much higher overall survival - 24.7 months in unmethylated and 36.3 months for methylated patients. I do not know if that means there is a benefit of Temodar to unmethylated patients, or just that patients in good enough shape 6 months after radiation to take Temodar will just do better in general. Bottom line - the old standard of Temodar and radiation (without Optune) is not really good enough and we need to find better ways forward.