Interactive decision tool · illustrative literature-alignment score, not a prognosis

Treatment-Optimization Atlas
RTK II glioblastoma

Today: 18 Sep 2026
ChemoRT starts in 10 days

A toggleable timeline for the same patient tracked in the companion pages, now with a confirmed plan: standard chemoradiation starting 28 Sep 2026 (Day 0), a Duke University immunotherapy trial under Dr. Henry Friedman afterward, and the CeGaT / cecava personalized neoantigen vaccine as supportive treatment. Every item below — standard care, both named programs, and a literature-sourced set of adjuncts and repurposed drugs — can be switched on or off to see how the live, transparent optimization score and its interaction warnings change. It starts pre-set to a literature-informed default.

Companion pages — RTK II Glioblastoma Trial Finder and Neoantigen & Personalized Peptide Vaccine Atlas (full CeGaT/cecava provider detail, cost, and logistics live there and are not repeated on this page).

Diagnosis GBM, IDH-wildtype, methylation class RTK II, MGMT methylated Age 48 Surgery 1.2 cm lesion, gross-total resection Day 0 28 Sep 2026 — chemoradiation start Plan ChemoRT → adjuvant TMZ → Duke immunotherapy trial + CeGaT vaccine

This is an information aid, not medical advice, and the optimization score is an illustrative literature-alignment heuristic — not a survival or outcome prediction. It is assembled from published literature and clinical-trial records and may contain errors or be out of date. It does not replace the treating neuro-oncology team, and nothing here should delay, replace, or be started ahead of what that team recommends. Every item marked for discussion should actually be discussed with Dr. Friedman's team, the Duke trial team, and/or CeGaT before being added to or removed from the real regimen.

On the lower-evidence items (ivermectin, fenbendazole, low-dose naltrexone) and the general antioxidant class: legal-to-obtain and proven-to-work are different questions. Ivermectin and fenbendazole have no completed human glioblastoma trial behind them — only preclinical data and, for fenbendazole, a widely circulated single-patient anecdote that was not glioblastoma. Both carry real drug-interaction considerations (CYP3A4, hepatic metabolism) alongside temozolomide, dexamethasone, and anti-seizure medication. Oral antioxidant supplements (vitamin C, curcumin, EGCG, resveratrol) carry a separate, general oncology caution about blunting radiotherapy's mechanism if taken during the concurrent chemoradiation window. These are included, toggleable, because they were specifically asked about — not as a recommendation. Discuss any of them with the treating team before use.

Interactive reference page: no account, no login — no data leaves your browser. Every toggle and estimated date you set is stored only in this browser's local storage; nothing is collected, transmitted, or sold, and this page is not affiliated with, nor endorsed by, Duke University, CeGaT/cecava, or any clinic, company, or trial named.

Regimen flow, chosen items only

A left-to-right view of what's currently switched on further down this page, grouped by phase with dates. Updates live as you toggle items — scroll horizontally on a narrow screen.

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Optimization score — literature alignment, not a prediction

Active interaction warnings

Active synergies

Decisions across 5 phases

3 are fixed standard-of-care (always included). The rest — the Duke trial and CeGaT vaccine, immune/NK support, marrow-recovery, repurposed drugs, a steroid-sparing strategy, every explicitly-requested weak-evidence item, the recruiting/soon trials pulled from the two companion dashboards, and the named private stem/immune-cell clinics — are toggleable. The score updates live as you switch items on or off.

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Total catalog items

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Fixed standard-of-care items

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On in the optimal preset

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Categories scored

Timeline phases

How the optimization score works

Fully transparent, on purpose — expand any item's detail panel to see exactly which category, evidence grade, and interactions are feeding the number.

1. Each category has a fixed weight (they sum to 100), split evenly across every item assigned to it, whether or not that item is currently switched on. Turning on more items in a category doesn't inflate the score — the category's ceiling stays the same.

2. Each active item's evidence grade scales its contribution the same way this whole site's evidence score works elsewhere:

Evidence	Contribution factor	Meaning
5/5	×1.00	Positive randomised phase 3
4/5	×0.85	Positive randomised phase 2
3/5	×0.65	Single-arm survival signal vs. historical control
2/5	×0.45	Early/observational signal, survival immature
1/5	×0.25	First-in-human or mechanistic only, no outcomes yet
Varies / not scored	×0.40	Protocol not yet confirmed (e.g. the Duke trial)
⚠ Caution	×−0.30	A trial of this specific approach was negative, or no human data exists at all for something with real risk

3. Interactions between active items adjust the total directly — a conflict (e.g. oral antioxidant vitamin C switched on during concurrent chemoradiation) subtracts points and raises a warning; a synergy (e.g. steroid-sparing switched on alongside the Duke trial) adds points. These only fire when both items in the pair are active, regardless of which phase you're looking at.

What this is not: a survival estimate, a probability, or a ranking of "better" vs. "worse" medicine in any absolute sense. It is a way to see, transparently, how a chosen combination stacks up against the literature gathered here — nothing more.

Category weight budget

Category	Weight	Items

Timeline, from Day 0

Grouped by phase. Fixed items show a locked pill; everything else has a toggle. Expand "Full detail" on any item for its mechanism, interactions, sources, and what to raise with the care team.

Questions to bring to the care team

Confirm the exact Duke trial protocol, NCT ID (if any), and expected start date — then update the estimate field on that item above. Confirm the CeGaT/cecava diagnostics send-off date and expected manufacturing timeline (~12 weeks) — then update its estimate field above. Ask explicitly about a steroid-sparing plan ahead of immunotherapy, and how lymphocyte counts will be tracked through chemoradiation. Before adding any repurposed drug (metformin, atorvastatin, doxycycline, mebendazole, disulfiram/copper, chloroquine/hydroxychloroquine) or supplement, confirm it against the actual chemotherapy, anti-seizure, and steroid regimen for interactions. If considering ivermectin, fenbendazole, or IV vitamin C, raise them by name — don't assume the team already knows they're being considered. Ask whether an OKN-007 combination trial arm is open and whether it could be layered onto, or would conflict with, the Duke trial enrollment. If any private stem/immune-cell clinic (Issels, a "Hope Clinic," or similar) is still being considered, get its exact protocol and any published outcome data in writing before the next appointment, and bring it to the treating team.