I find TMZ very tolerable. I take a Zofran 1 hr pre dose each night. Bio markers of tumor can indicate if TMZ will be effective. I am now on it 5 days a month with dosage adjustment every other month after labs and follow up mri. Optune dose require a coach. Staff is script based and. Has never experienced living with the unit. They refer you back to oncologist again a person with limited experience with unit. Part of the training should be having to wear the unit for a few weeeks. Electrode conductive glue deteriorate withe perspiration so summer time May require pad change daily. A good chemical engineer should be able to find a better adhesive. Like on EKG and Holter tabs. They seem to bond to skin.