Glioblastoma Clinical Trials

• Patient is aged \>35 years (age range of more likely to suffer from an IDHwt World Health Organisation (WHO) grade 4 astrocytoma)\*

• Patient is male or female.

• Patient has a new radiological diagnosis of glioblastoma.

• Patient has a performance status judged by WHO, Eastern Cooperative Oncology Group (ECOG) score = 0-1.

• Patient has been reviewed by Neuro-oncology multidisciplinary team (MDT - neurosurgeon, clinical oncologist, radiologist and pathologist); MDT consensus that offering study entry is clinically appropriate and safe i.e. patient unlikely to come to harm (e.g. hydrocephalus) from delayed surgery and pre-operative Optune based on available clinical information and imaging.

• PI has confirmed at the first clinic visit that study entry is clinically appropriate and safe (e.g. lack of severe and debilitating symptoms of raised intracranial pressure).

• There is intention to treat the patient with surgical resection and postoperative adjuvant therapy as per current standard of care (40Gy/15 fr or 60Gy/30fr).

• Patient has adequate haematological and biochemical parameters for surgery and contrast agent administration (full blood count and coagulation profile deemed acceptable by clinical team, eGFR \>30ml/min).

• Patient has mental capacity to consent for treatment.

• Patient is able and willing to give informed consent

⁃ Criteria specific to the experimental arm:

• Patient is able and willing to comply with study protocol requirements to continuously shave their head

• Patient is able and willing to comply with study protocol requirements to wear Optune equipment for the required duration.