Pancreatic Cancer

Outside Approval Square

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 cancer. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces a variety of therapeutic effects enabling the patient to be treated without incisions or radiation.

Current treatment options for pancreatic cancer include combinations of surgery, radiation, chemotherapy, embolization or other ablative methods, yet these are not 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.

Advantages:

  • Focused ultrasound is non-invasive and therefore has reduced risk for infection and blood clots, and shorter recovery time.
  • Precise targeting minimizes damage to non-targeted healthy tissue.
  • No ionizing radiation, enabling repeat treatment if necessary.
  • Treatment can be a complement to drug therapy, enabling enhanced delivery of chemotherapy or immunotherapy to tumors.
  • May potentially induce an anti-tumor immune response.
Clinical Trials Square

Clinical Trials

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.

The Focused Ultrasound Foundation is working with leading sites to implement a 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.

See here for a list of treatment sites
See here for a list of clinical trials sites
See here for a list of laboratory research sites

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.

Pre-clinical Laboratory Studies

Pre-clinical 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.

Additional Resources

Notable Papers

Farr N, Wang YN, D'Andrea S, Starr F, Partanen A, Gravelle KM, McCune JS, Risler LJ, Whang SG, Chang A, Hingorani SR, Lee D, Hwang JH. Hyperthermia-enhanced targeted drug delivery using magnetic resonance-guided focussed ultrasound: a pre-clinical study in a genetic model of pancreatic cancer. Int J Hyperthermia. 2017 Jul 17:1-8. doi: 10.1080/02656736.2017.1336675.

Maeda M, Muragaki Y, Okamoto J, Yoshizawa S, Abe N, Nakamoto H, Ishii H, Kawabata K, Umemura S, Nishiyama N, Kataoka K, Iseki H. Sonodynamic Therapy Based on Combined Use of Low Dose Administration of Epirubicin-Incorporating Drug Delivery System and Focused Ultrasound. Ultrasound Med Biol. 2017 Oct;43(10):2295-2301. doi: 10.1016/j.ultrasmedbio.2017.06.003. Epub 2017 Jul 10.

Shi Y, Ying X, Hu X, Shen H. Pain management of pancreatic cancer patients with high-intensity focused ultrasound therapy. Pak J Pharm Sci. 2017 Jan;30(1 Suppl):303-307.

Zhao J, Zhao F, Shi Y, Deng Y, Hu X, Shen H. The efficacy of a new high intensity focused ultrasound therapy for locally advanced pancreatic cancer. J Cancer Res Clin Oncol. 2017 Jun 15. doi: 10.1007/s00432-017-2459-6.

Dababou S, Marrocchio C, Rosenberg J, Bitton R, Pauly KB, Napoli A, Hwang JH, Ghanouni P. A meta-analysis of palliative treatment of pancreatic cancer with high intensity focused ultrasound. J Ther Ultrasound. 2017 Apr 1;5:9. doi: 10.1186/s40349-017-0080-4.

Scott SJ, Adams MS, Salgaonkar V, Sommer FG, Diederich CJ. Theoretical investigation of transgastric and intraductal approaches for ultrasound-based thermal therapy of the pancreas. J Ther Ultrasound. 2017 May 3;5:10. doi: 10.1186/s40349-017-0090-2. eCollection 2017.

Yu MH, Lee JY, Kim HR, Kim BR, Park EJ, Kim HS, Han JK, Choi BI. Therapeutic Effects of Microbubbles Added to Combined High-Intensity Focused Ultrasound and Chemotherapy in a Pancreatic Cancer Xenograft Model. Korean J Radiol. 2016 Sep-Oct;17(5):779-88. doi: 10.3348/kjr.2016.17.5.779.

Diana M, Schiraldi L, Liu YY, Memeo R, Mutter D, Pessaux P, Marescaux J. High intensity focused ultrasound (HIFU) applied to hepato-bilio-pancreatic and the digestive system-current state of the art and future perspectives. Hepatobiliary Surg Nutr. 2016 Aug;5(4):329-44. doi: 10.21037/hbsn.2015.11.03.

Strunk HM, Henseler J, Rauch M, Mücke M, Kukuk G, Cuhls H, Radbruch L, Zhang L, Schild HH, Marinova M. Clinical Use of High-Intensity Focused Ultrasound (HIFU) for Tumor and Pain Reduction in Advanced Pancreatic Cancer. Rofo. 2016 Jul;188(7):662-70. doi: 10.1055/s-0042-105517.

Click here for additional references from PubMed.