Optune delivers Tumour Treating Fields (TTFields) therapy for glioblastoma (GBM). Prescribing and monitoring treatment requires a structured approach to support treatment use and help patients adapt to the practicalities of using the device.

Here we share some practical clinical considerations based on our experience of prescribing Optune and supporting patients using it.

These tips are intended for clinicians experienced in treating patients with GBM, so we do not cover the general management of glioblastoma or chemoradiotherapy. They are not a replacement for Novocure’s prescribing information, training or guidance on the use of Optune.

1. Patient eligibility and initial assessment

The EF-14 trial evaluated the addition of Tumour Treating Fields to maintenance temozolomide in patients with newly diagnosed glioblastoma.

The decision to use Optune is an individual one. Different patients feel differently about wearing and managing the device, so discussions should include both the clinical considerations and the practical realities of incorporating Optune into everyday life.

We strongly encourage prospective patients to speak to people who have experience of using Optune. The Optune Support UK Open Groups give patients and families an opportunity to hear directly from others about the realities of treatment and ask practical questions.

Clinicians should check the current Optune prescribing information for contraindications before treatment, including those relating to active implanted medical devices such as pacemakers and defibrillators.

It is also important to consider the patient’s lifestyle, social circumstances and available support. Optune places additional day-to-day demands on both patients and carers. While many patients adapt well over time, identifying where additional support may be needed can make the transition easier.

Wear time should also be discussed from the outset. Rather than thinking about specific periods of the day when they will use Optune, we encourage patients to think about how they can incorporate the device into everyday life and maximise their wear time, with breaks where needed for activities such as showering, scalp care and array changes.

2. Prescribing Optune

Optune is relatively straightforward to prescribe. A prescription form needs to be completed and signed by both the prescribing physician and the patient before being sent to Novocure.

Novocure will then arrange for a Device Support Specialist to set the patient up with the device at home and provide the necessary training.

In our experience, this process takes approximately 2–3 weeks, so we recommend starting it during chemoradiotherapy where appropriate.

Our usual practice is to aim to start Optune approximately two weeks after completion of chemoradiotherapy, according to the patient’s individual treatment plan.

3. Patient education and training

Good patient education can make the transition to Optune more manageable and help patients understand both the treatment and what using the device will involve in everyday life.

We try to cover several key areas:

• How Optune works – explain Tumour Treating Fields and the role of Optune within the patient’s treatment plan.
• Using the device – make sure patients and carers understand the practicalities of wearing, charging and managing the equipment.
• Skin care – explain how to care for the scalp and the importance of identifying and treating irritation early.
• Array changes – make sure patients and carers feel confident with the practicalities of changing arrays.
• Wear time – discuss the importance of maximising wear time and how Optune can be incorporated into everyday activities.
• Lifestyle adaptation – talk about work, sleep, travel, exercise and other practical considerations.
• Support – make sure patients and carers know where to go with clinical, technical and practical questions.

4. Monitoring and follow-up care

Once patients are established on Optune, follow-up provides an opportunity to review wear time, skin condition and any practical difficulties they are experiencing.

For patients established on Optune, we normally recommend a clinical review approximately every three months, although more frequent reviews will usually take place during adjuvant chemotherapy.

Our usual pattern is:

Early post-start consultation

We usually arrange an early review approximately 3–10 days after starting Optune.

By this point, the patient and carer will have had some experience of using the device and will usually have completed at least one array change. This makes it a useful opportunity to identify early difficulties and answer practical questions.

We also make sure patients and carers have details of the Optune Support Group and have been offered access to the Optune Support UK WhatsApp group.

4-6 week consultation

Where possible, this can coincide with the patient’s next chemotherapy appointment.

We review wear time and skin condition, discuss any practical difficulties and check that patients know about the support available to them, including the Optune Support Group.

Ongoing follow-up

Further reviews provide an opportunity to monitor how the patient is managing Optune, address skin problems and discuss any changes in treatment or circumstances that may affect their use of the device.

5. Troubleshooting and scalp care

Skin side-effects can often be managed more effectively when identified and treated early. Patients should therefore be encouraged to report skin problems promptly, before irritation or damage becomes more significant.

Our approach focuses on:

1. Identify problems early – do not wait until the skin becomes significantly irritated or damaged.
2. Rotate electrode contact points – adjust contact points within the prescribed array placement to help prevent irritated areas from becoming worse.
3. Prevention is better than cure – encourage good scalp care, including soaking the arrays off in the shower, meticulous shaving and moisturising the skin.
4. Use a staged approach to skin-care medication – our approach starts with 1% hydrocortisone cream, escalating treatment where needed.
5. Access specialist support when needed – we have access to dermatologists with experience of supporting patients using Optune when additional input is required.

Patients should be encouraged to contact their clinical team promptly if they develop significant or persistent scalp problems.

6. Combining Optune with other therapies

The EF-14 trial evaluated Tumour Treating Fields alongside maintenance temozolomide following chemoradiotherapy.

Optune has also been used alongside other therapies, including lomustine, carboplatin and bevacizumab. In general, the side-effect profile associated with Optune is different from that of many systemic anti-cancer treatments, which can make concurrent treatment possible in appropriate patients.

Decisions about combining Optune with other therapies should be made on an individual basis by the treating neuro-oncology team.

What did the TRIDENT trial show?

The Phase III TRIDENT trial investigated whether starting Tumour Treating Fields at the beginning of chemoradiotherapy improved outcomes compared with starting TTFields during the subsequent maintenance phase.

Topline results reported in June 2026 showed that the trial did not meet its primary endpoint. Median overall survival was 17.7 months in the early-start group compared with 17.5 months in the maintenance-start group, a difference that was not statistically significant. No new safety signals were identified.

Clinicians should refer to current prescribing guidance and emerging published evidence when considering the timing of TTFields treatment.

7. Surgery and treatment interruptions

Patients may need to interrupt Optune treatment if they require further surgery.

For patients undergoing repeat surgery, our usual approach is to continue Optune up until surgery, provided the scalp and skin remain intact.

Following surgery, we normally recommend waiting at least two weeks before restarting Optune and carefully checking that the wound has healed sufficiently before treatment resumes.

The timing of restarting treatment should ultimately be determined by the treating clinical team based on the patient’s wound healing and individual circumstances.

Supporting patients beyond the clinic

Prescribing Optune is only part of the process. Patients and families may also need practical support as they adapt treatment around everyday life.

Optune Support UK provides opportunities for patients and carers to connect with others who have experience of using Optune, alongside practical information and resources that clinicians can share with their patients.

Supporting a patient who is starting Optune? Read our Patient education: Resources to help clinicians guide patients through the Optune process for further practical information.