Closing the loop on glioblastoma: A roadmap toward developing bioelectronics for continuous monitoring of tumor state

Closed-loop bioelectronic devices offer a promising platform for responsive treatment to heterogeneous disease states. Glioblastoma, an aggressive form of brain cancer, has recently emerged as a focus of bioelectronic medicine through delivery of electrotherapies. This perspective article posits that true progress in the management of this extremely heterogeneous disease requires the integration of continuous monitoring from the tumor microenvironment as well as on-device analytics to enact closed-loop control. Four promising candidate biological changes present in the glioblastoma microenvironment are highlighted (local field potentials, bioimpedance, local pH, biomarkers) alongside the bioelectronic sensors that can enable the development of multifunctional bioelectronic devices to monitor the changes. Finally, three key principles (patient involvement, data analytics, and device fabrication) governing the successful implementation of closed-loop sensors are proposed to create a roadmap for academics and industry partners to successfully develop multimodal devices for the treatment of glioblastoma.