NCCN has designated Optune as first line therapy. Seems to contradict you statement. "NCCN - CATEGORY 1 Part of a National Comprehensive Cancer Network® (NCCN®)Category 1 Recommendation for newly diagnosed GBM5 The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Central Nervous System Cancers include alternating electric field therapy (Optune®) together with temozolomide (TMZ) following maximal safe resection and standard brain radiation therapy with concurrent TMZ as a Category 1 recommended treatment option for patients with newly diagnosed supratentorial GBM and good performance status. The NCCN-preferred adjuvant treatment regimen is radiation therapy with concurrent and adjuvant TMZ +/- Optune. There is uniform NCCN consensus for this recommendation based on high-level evidence (Category 1).5,‡"
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