Focused Ultrasound Therapy
Focused ultrasound is a rapidly evolving, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with metastatic cancer. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue.
How it Works
Where the beams converge, focused ultrasound produces several therapeutic effects that are being evaluated.
One mechanism is the precise ablation (thermal destruction of tissue), which enables metastatic cancer to be treated without surgery. This destruction can be done to completely destroy the target or to partially treat it, and partial treatment is believed to stimulate the patient’s immune response, which may have a broader impact.
Another mechanism is to produce local hyperthermia of the targeted tissue, which can have a variety of beneficial effects including the release of chemotherapy drugs that are contained in temperature sensitive molecules. This allows delivery of a higher level of chemotherapy precisely to the targeted tissue, while limiting the effects for the rest of the body. Hyperthermia can also increase the absorption of the therapeutic agents to the targeted tissue.
Advantages
The primary options for treatment of metastatic disease are medication or invasive surgery.
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 may also enhance chemotherapy impact to the target, with less impact to the rest of the body
Clinical Trials
One clinical trial – in patients up to 30 years of age – is using thermosensitive liposomal Doxorubicin that is administered intravenously, and is only released in the tumor where focused ultrasound is applied. This can improve the penetration of the doxorubicin to the cancer, while limiting the exposure to the rest of the body.
A second study is treating a variety of solid tumors.
A third study is assessing focused ultrasound in treating a number of malignancies in the pelvis.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for these metastatic cancers are not approved by regulatory bodies or covered by medical insurance companies.
Notable Papers
Schwartz MR, Debski AC, Price RJ. Ultrasound-targeted nucleic acid delivery for solid tumor therapy. J Control Release. 2021 Oct 14;339:531-546. doi: 10.1016/j.jconrel.2021.10.010.
Souri M, Soltani M, Moradi Kashkooli F. Computational modeling of thermal combination therapies by magneto-ultrasonic heating to enhance drug delivery to solid tumors. Sci Rep. 2021 Oct 1;11(1):19539. doi: 10.1038/s41598-021-98554-z.
Tonguc T, Strunk H, Gonzalez-Carmona MA, Recker F, Lütjohann D, Thudium M, Conrad R, Becher MU, Savchenko O, Davidova D, Luechters G, Mustea A, Strassburg CP, Attenberger U, Pieper CC, Jenne J, Marinova M. US-guided high-intensity focused ultrasound (HIFU) of abdominal tumors: outcome, early ablation-related laboratory changes and inflammatory reaction. A single-center experience from Germany. Int J Hyperthermia. 2021 Sep;38(2):65-74. doi: 10.1080/02656736.2021.1900926.
Zhu L, Partanen A, Talcott MR, Gach HM, Greco SC, Henke LE, Contreras JA, Zoberi I, Hallahan DE, Chen H, Altman MB. Feasibility and safety assessment of magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU)-mediated mild hyperthermia in pelvic targets evaluated using an in vivo porcine model. Int J Hyperthermia. 2019;36(1):1147-1159. doi: 10.1080/02656736.2019.1685684.
Zhai YP, Wang Y. Effect of the combination treatment of high-intensity focused ultrasound and cryocare knife in advanced liver cancer. J BUON. 2017 Mar-Apr;22(2):495-499.
Facciorusso A, Serviddio G, Muscatiello N. Local ablative treatments for hepatocellular carcinoma: An updated review. World J Gastrointest Pharmacol Ther. 2016 Nov 6;7(4):477-489.
Gong Y, Wang Z, Dong G, Sun Y, Wang X, Rong Y, Li M, Wang D, Ran H. Low-intensity focused ultrasound mediated localized drug delivery for liver tumors in rabbits. Drug Deliv. 2016 Sep;23(7):2280-2289. Epub 2014 Nov 4.
Click here for additional references from PubMed.
