That’s usually the first thought that comes to mind when considering tumor-treating fields (TTF). But whether you understand its voodoo or not, it’s hard to contest its survival advantage when administered with temozolomide after definitive chemoradiation for patients with glioblastoma. An advantage that was demonstrated even at its 2015 interim analysis at the meager price of an alpha-level of 0.006. What’s more, it appears to improve QoL if anything. To further warm oncologists’ cold feet, the final analysis of EF-14 is now hot off the press. At a median follow-up of 40 months, it confirms a significant overall survival advantage when compared to temozolomide-maintenance alone. These survival times were 21 versus 16 months, respectively, which is even more impressive considering they were measured from time of randomization after completion of chemoradiation. The bad news is bad actors were excluded: ones with any signs of progression prior to randomization, severe comorbidities, or infratentorial tumor location (ok, that one’s just logistics). The good news is post-hoc analyses demonstrated a consistent advantage across all ages and MGMT-methylation statuses. This all leaves us wondering: what’s an unconventional life-prolonging treatment gotta do to get a category 1 recommendation around here?


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