Focused Ultrasound Therapy
Focused ultrasound is an early stage, noninvasive therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with pancreatic tumors. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue. Current application is mostly malignant tumors, with the exception being insulinoma, which has its own listing under disease and conditions as the impact of insulin secretion has unique implications.
How it Works
Where the beams converge, focused ultrasound can produce precise ablation (thermal destruction of tissue). The goal could be complete ablation of the cancer or it can be done partially, and partial ablation may help awaken the immune system for a more generalized response. This ablation can also be targeted at the innervation of the pancreas, to help lessen the pain from the disease.
Current treatment options are focused on pancreatic cancer, and include combinations of surgery, radiation, chemotherapy, embolization or other ablative methods, yet these still not very effective for many patients.
Focused ultrasound – used alone and in combination with other therapies – is being investigated to treat pancreatic cancer and the pain associated with the disease. Focused ultrasound has the potential to achieve symptomatic relief by improving the resection of the tumor prior to surgery, by reducing tumor size and spread, and by reduction in overall tumor pain.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary.
Focused ultrasound can also be a complement to drug therapy, enabling enhanced delivery of chemotherapy or immunotherapy to tumors. It may potentially induce an anti-tumor immune response.
A clinical trial in Stanford, California, will be treating patients with adenocarcinoma of the pancreas.
A study in Oxford, UK, will treat patients with pancreatic cancer with focused ultrasound. Those interested in learning more about this trial can contact the site's study coordinator.
The University of Roma La Sapienza is leading a study to assess the feasibility and clinical performance of focused ultrasound ablation of unresectable pancreatic cancer in pain palliation and tumor control.
A clinical trial in Norway is using focused ultrasound with microbubbles to enhance the uptake of chemotherapy in patients with pancreatic ductal adenocarcinoma.
The Focused Ultrasound Foundation has established the ARRAY registry to capture data from pancreatic cancer patients to help guide future decisions about optimal clinical care, safety and regulatory factors, and reimbursement concerns. The goal of this registry is to capture early data to expedite the availability of focused ultrasound improvements for patient care as soon as possible.
Researchers in Japan are using sonodynamic therapy to release chemotherapeutic agents in patients with pancreatic cancer.
Regulatory Approval and Reimbursement
The Model JC system manufactured by Chongqing Haifu has been approved in Europe for palliative treatment in patients with pancreatic cancer.
Focused ultrasound treatment for patients with pancreatic cancer is not universally reimbursed by medical insurers.
Preclinical Laboratory Studies
Preclinical studies are underway to investigate the use of non-ablation mechanisms of focused ultrasound in the treatment of pancreatic cancer. Examples of these studies include:
- Focused ultrasound to induce an immune response that could be combined with immunotherapeutics to treat both local and systemic disease.
- Focused ultrasound to enable targeted delivery and/or activation of drugs via carrier vehicles (e.g. microbubbles, nanoparticles, liposomes) to enable delivery of high concentrations in the tumor with minimal systemic side effects.
Suggested Reading: Focused Ultrasound for Pancreatic Cancer (PDF), July 2019.
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