Liver Cancer


Outside Approval SquareLiver cancer is the fifth most common malignancy worldwide, with an annual incidence of more than 550,000. Primary liver cancer tends to occur in previously damaged livers, as in cases of viral hepatitis, alcohol abuse, and obesity.

The liver is the second most common site for metastases. The worldwide annual incidence of liver metastases is 2 million. Common sources of liver metastases are colorectal, breast, and lung cancer.

Current Treatment

Traditional treatment options include surgery, chemotherapy, radiotherapy, localized destruction of the tumor tissue (via radiofrequency ablation, alcohol injection, cryosurgery, or laser photocoagulation), or combination of two or more of these options. The long-term solution for primary liver cancer is often liver transplantation. For secondary liver cancer, surgical resection is the gold standard and it is curative for suitable patients (about 20%).

Focused Ultrasound Treatment

Focused ultrasound is a completely non-invasive way to thermally destroy tumors in the liver. Using focused ultrasound in conjunction with image guidance, the physician directs a focused beam of acoustic energy to heat and destroy the targeted tumor tissue. This technique could offer patients who are not candidates for surgery a non-invasive, low-morbidity, single treatment with a short recovery time. A publication on using heat activated liposomes that contain chemotherapy was recently released. 

Focused ultrasound is currently approved to treat liver cancer in Europe and China, with tens of thousands of patients treated to date. These procedures have been done using ultrasound guidance, as either a stand-alone treatment or in combination with chemotherapy. 

Clinical Trials

One study will be using focused ultrasound to treat liver tumors prior to hepatic resection. There is a clinical trial for liver cancer and metastatic liver tumors in pediatric patients and young adults. A second study involves enhancing drug delivery due to heating the thermosensitive lysosome containing chemotherapy with focused ultrasound.

There are also some studies that are treating specific non-liver tumors that have spread to the liver. These are typically listed by the tissue type of the original tumor. For example, ‘colorectal cancer with metastatic spread to the liver.’

The Foundation’s Liver and Pancreas Program is working with the medical community to accelerate the research and development of focused ultrasound to treat these deadly cancers.

For a full list of clinical trials, please click here.

Regulatory Approval and Reimbursement

A focused ultrasound system has been approved in China and in Europe for treatment of liver cancer.

To the best of our knowledge, the use of focused ultrasound to treat liver cancer is not yet widely reimbursed by medical insurance.

Treatment Sites

There are many international sites which are treating liver cancer using the equipment manufacturered by Chongquing Haifu Technology.  Click here to see a list of treatment sites.

Notable Papers

Paul C. Lyon, Lucy F. Griffiths, Jenni Lee, Daniel Chung, Robert Carlisle, Feng Wu, Mark R. Middleton Email author, Fergus V. Gleeson and Constantin C. Coussios. Clinical trial protocol for TARDOX: a phase I study to investigate the feasibility of targeted release of lyso-thermosensitive liposomal doxorubicin (ThermoDox®) using focused ultrasound in patients with liver tumours. Journal of Therapeutic Ultrasound. 20175:28

Zhai YP1, 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.

Wu L, Zhang YS, Ye ML, Shen F, Liu W, Hu HS, Li SW, Wu HW, Chen QH, Zhou WB. Overexpression and correlation of HIF-2α, VEGFA and EphA2 in residual hepatocellular carcinoma following high-intensity focused ultrasound treatment: Implications for tumor recurrence and progression. Exp Ther Med. 2017 Jun;13(6):3529-3534. doi: 10.3892/etm.2017.4428. Epub 2017 May 4.

Gélat P, Ter Haar G, Saffari N. A comparison of methods for focusing the field of a HIFU array transducer through human ribs. Phys Med Biol. 2014 May 27;59(12):3139-3171.

Jean-Francois Aubry, Kim Pauly, Chrit Moonen, Gail ter Haar, Mario Ries, Rares Salomir, Sham Sokka, Kevin Sekins, Yerucham Shapira, Fangwei Ye, Heather Huff-Simonin, Matt Eames, Arik Hananel, Neal Kassell, Alessandro Napoli, Joo Hwang, Feng Wu, Lian Zhang, Andreas Melzer, Young-sun Kim, Wladyslaw M Gedroyc. The road to clinical use of high-intensity focused ultrasound for liver cancer: technical and clinical consensus. Journal of Therapeutic Ultrasound 2013, 1:13; 2013 Aug 1.

Orsi F, Arnone P, Chen WZ, Zhang LA. High intensity focused ultrasound ablation: A new therapeutic option for solid tumors. J Cancer Res Ther 2010 Oct-Dec;6(4):414-20.

Click here for additional references from PubMed.

Video courtesy of InSightec