Brain cancer patients live longer with this electric skull cap
As I’ve written before, glioblastoma is just about the worst type of cancer it’s possible to get. Drugs struggle to be effective because of the blood-brain barrier, and surgery is possible but often ineffective, because of the need to remove every trace of the tumour in an incredibly delicate environment. If any trace remains, the tumours will most likely return. Average survival rates are around 15 months, and just 10% will still be alive within five years of a diagnosis.
A new clinical trial has provided some hope, edging those survival rates up a touch, and while a brain-cancer diagnosis is still among the worst possible, it’s encouraging that any progress is being made at all. 695 patients were treated for glioblastoma – half of which were given the chemotherapy drug temozolomide, while the other half were given both the drug and instructed to wear an electric skull cap called Optune for at least 18 hours per day.
Why would an electric skull cap make a difference? The thinking is that the continuous alternating electric fields delivered by the device block cell division, slowing the progress of the cancer. The results would suggest it’s doing something, even if that’s not the exact reason.
The median survival rate for the group simply taking temozolomide was 16 months, while those that took the drug alongside the Optune skull gap had a median survival period of 21 months. What’s more, compared to the drugs-only group, longer-term survival rates were up too: from 31% to 43% after two years; from 16% to 26% after three; from 8% to 20% after four; and 13% of those wearing the skull cap lived to see a fifth year, compared to just 5% of the group on drugs alone.
Dr Roger Stupp, a professor of neurological surgery at Northwestern University, sees this as an important shift in how we treat brain cancer. “When I started treating patients with GBM 20 years ago, the majority of patients died within less than one year and long-term survival was nearly absent,” he said. “Now, we see a meaningful improvement in survival at two years and beyond. With the combination of Optune and temozolomide, one out of seven patients is living longer than five years.”
There is, unfortunately, a downside – and as it so often is with cancer treatment, the downside is financial. As the Associated Press notes, the therapy costs a huge $21,000 per month thanks to it being “an extremely sophisticated medical device, made in very low quantities”. Disposable parts need changing several times per week, and every patient has a support person. In the US, some health-insurance companies cover it, while others do not.
Price aside, it’s a fascinating development in the treatment of a particularly cruel form of the world’s cruellest disease. And for now, it’s the best we’ve got, although we have our fingers crossed that the amazing progress on rats with brain cancer can be replicated in humans soon.