Optune- A Wearable Cap for Treating Brain Cancer

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Glioblastoma is known as one of the most deadly types of cancer that affect the brain or central nervous system. The standard treatment for the patients suffering from such cancer is an invasive surgery, followed by a radiation therapy and a ‘Temozolomide’ chemo session for about a year. This treatment gives the patient a rough 27% chance for survival, which makes two years of lifetime.

Novocure Ltd, after 5 years long clinical trials, put forward an innovative and tremendously effective therapy for treating brain cancer. This concept may seem fictional at first, but researchers have provided evidence of its effectiveness. An electric skull cap– known by the name Optune, has been designed specifically for the patients suffering from brain cancer. It works by zapping the growth of cancerous cells in the brain of the wearer. Adding this cap to the standard regimen produces better survival rates.

Who can use Optune?

The treatment is only feasible for patients with glioblastomas, i.e. brain or spine tumors. It works specifically on these body parts because there are cells found in the brain that are not dividing, hence the treatment can be targeted to only the dividing cancerous ones.

How does Optune work?

The cap is powered by a portable power supply that sends a defined low intensity AC frequencies, known as the tumor treatment fields (TTFields), to the brain of the cancer patient via electrodes placed onto the clean hairless scalp on the brain. These frequencies are the main working agents that disrupt the process of mutating cell division which is the basic cause the cancer cells growth.

In specific terms, the TTFields prevent the chromosomes from dividing by making use of an intermediate frequency of AC to exert a certain force on the molecules physically that the basic division mechanism of cancer cells, residing in the cancerous area under treatment, gets disrupted and gradually leads to the death of cancerous cells.  

Optune uses a TTField of 200 kHz frequency, which gets affects only the glioblastoma cells and keeps the other brain cells and neurons unharmed. TTField is safe for use as it has low levels of toxicity.

The cancer patients are supposed to wear this electric cap for a period of at least 18 hours every day, along with the standard chemotherapy treatment with Temozolomide.

Novocure recently went for a major up-gradation of Optune with a reduction in the size and weight of the device’s AC field generator, along with its battery pack. The product launched initially came in a backpack and weighed almost 3 kilograms (6 pounds), while the upgraded version is available in a shoulder carry bag and weighs only 1.2 kilograms (2.7 pounds). All you have to do is either plug the device directly into the socket or change its batteries, every few hours.

Survival rate:

The clinical trial lasted for the duration of 5 years; from July 2009 to November 2014, with 695patients newly diagnosed with glioblastoma multiforme. The data collected during the trial shows that the rate of patients with glioblastoma had a survival improvement increasing from 5% to almost 13% during the third phase of study i.e. double the efficiency in comparison to survival results achieved without Optune.

The clinical trials revealed that, after two years of using the technology, 43% of the patients using Optune were still alive, in comparison to the other 30% patients who chose standard treatment regimen. After four consecutive years of Optune use, the survival rate with this technology was seen to be a remarkable 17% in contrast to the 10% for the non-users. Chief Science Officer of the company- Eilon Kirson says:

“To patients, that’s a big difference. That’s worth fighting for.” 

Side effects:

A slight sensation of warming up and mild irritation has been reported by the subjects, but other than that, neither has it caused any adverse effects on health, nor has the cap caused any interruption in the patient’s day-to-day life.

Although there could be various patients and doctors who would prefer over this therapy because of the comfort level since Optune requires you to wear the hardware 24-7 but for those willing to adapt to it will certainly gain better results.

The Cost of therapy:

This eccentric new technology is available at a cost of around $700 per day and can cost almost $21,000 per month. Now, what the good news is that the FDA approved Optune caps is covered by a great majority of the US insurers.

On Thursday, the company released its third quarter annual report showing that it surpassed the consensus estimate of ($0.39) by reaching $0.13 i.e. leading to a business earning of $30.20 million during this quarter versus the estimated $26.95 million.

Doctors’ Reaction:

While the company received a very positive response from various doctors, many oncologists are still skeptical. Kirson admits by saying:

“The adoption rate has not been stellar to date”

He is also hopeful that the long-term data will probably be convincing to the neuro-oncologists. He said:

“The therapy really revolutionizes glioblastoma care, and more than that: It introduces a new modality that will hopefully transform cancer care.”

Since Optune relies on a physical mechanism of treatment rather than chemical mechanism, the application of this therapy is broad and can be used to treat cancer of different genetics and subtypes. Novocare is now reported to have been working on treating aggressive pancreatic, lung as well as ovarian cancer with a similar kind of therapy.

Dr. Roger Stupp- A brain tumor expert and professor of neurological surgery at Northwestern University, Chicago and an invigilator of the Optune study says that no major innovation treatment for glioblastoma has taken place since ten years when chemotherapy got added to the radiotherapy. He further described the importance of Optune and said:

“This gives, at least for some patients, a long-term hope for control,” he said, “and it gives additional quality time.”

He also says:

“Our results demonstrate a proof-of-concept that this treatment modality actually works, and can prevent tumor cells from growing and dividing. And it does increase the survival rate at two years, three years, and even at five years, in a substantial amount. It is the first treatment to improve overall [results] in over a decade.”

About the Company and Future work:

Novocure Limited, the sole creator of this innovative technology, is a commercial oncology firm that works on creating therapies using TTFields- (tumor treatment fields) to treat solid cancer tumors. The company got approved in the US in the year 2011, for conducting trials on glioblastoma patients who went out of options. It was then in 2015 that the FDA finally approved the technology for newly diagnosed cancer patients. The treatment is now available in Japan and Europe. It is also at an approximate 500 different US medical centers, including the Nebraska Medical Center.

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