Novocure treated tumors with fields instead of molecules

Novocure's Optune came from a non-obvious question: could an external device interfere with cell division without being a drug? Tumor Treating Fields use alternating electric fields in a wearable system, aimed at rapidly dividing tumor cells.

A 2017 review summarized the mechanism: TTFs disrupt mitosis, induce cell-cycle arrest and apoptosis in preclinical work, and were evaluated in randomized phase III trials for glioblastoma. The same review notes FDA approvals for recurrent glioblastoma in 2011 and newly diagnosed glioblastoma in 2015.

The FDA's 2015 PMA supplement records Optune, formerly NovoTTF-100A, as a low-electric-field tumor treatment device and states the new indication with temozolomide for adults with newly diagnosed glioblastoma after surgery and radiation with standard chemotherapy.

Use physics against mitosis

The device uses a physical vulnerability of dividing cells instead of a biochemical target.

Transducer arrays turned therapy into something that could be delivered continuously outside the hospital.

The approach made frequency, field strength and array placement the design variables.

Regulatory approval showed that a device pathway could carry a treatment modality usually imagined as pharmaceutical.

A hard biological problem can sometimes be attacked by changing modality: from chemistry to a physical field with its own selectivity constraints.

Optune remained a specialized, burdensome therapy, but it established Tumor Treating Fields as a real medical-device modality. Novocure later pursued additional indications and device variants, including other solid tumors.