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

Pancreatic Cancer Action Network
National Pancreatic Cancer Foundation

Notable Papers

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.

Marinova M, Strunk HM, Rauch M, Henseler J, Clarens T, Brüx L, Dolscheid-Pommerich R, Conrad R, Cuhls H, Radbruch L, Schild HH, Mücke M. [High-intensity focused ultrasound (HIFU) for tumor pain relief in inoperable pancreatic cancer : Evaluation with the pain sensation scale (SES)]. Schmerz. 2016 Jul 11. German.

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.

Ning ZY, Cheng CS, Xie J, Chen QW, Xu LT, Zhuang LP, Zhang CY, Song LB, Shi WD, Zhu XY, Wang P, Wang K, Meng ZQ. A retrospective analysis of survival factors of high intensity focused ultrasound (HIFU) treatment for unresectable pancreatic cancer. Discov Med. 2016 Jun;21(118):435-45.

Lv W1, Yan T1, Wang G1, Zhao W1, Zhang T1, Zhou D1. High-intensity focused ultrasound therapy in combination with gemcitabine for unresectable pancreatic carcinoma. Ther Clin Risk Manag. 2016 May 2;12:687-91. doi: 10.2147/TCRM.S90567.

Click here for additional references from PubMed. 

     

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