Collaboration: Fueling a Changing Focused Ultrasound Landscape

Written by Jessica L. Foley, PhD

Promising areas of focused ultrasound, including brain applications and cancer immunotherapy, are benefiting from this culture of collaboration. Recently, there have been many exciting developments in the field of focused ultrasound that are demonstrating the potential of this early-stage, noninvasive therapeutic technology to treat a wide range of serious medical disorders.

Due to focused ultrasound’s ability to elicit more than 18 distinct bio-effects in the body – including destroying tissue, delivering drugs in high concentrations, enhancing radiation therapy and stimulating an immune response – it is now approved or under investigation to treat more than 70 conditions ranging from neurological disorders to cancers, and beyond. Recent Food and Drug Administration approvals for the treatment of essential tremor and prostate diseases have propelled the technology into many clinics and academic medical centers around the world, expanding patient access to this exciting new therapy. As these and emerging clinical applications of focused ultrasound advance through clinical trials and gain critical regulatory approvals, and new fields of research take off, it is clear that collaboration has helped to fuel progress and bring successes at a faster pace.

The tools of a new research paradigm
Over the last several years, foundations are playing an increasingly critical role in moving research discoveries to the clinic and to commercialization. As many companies have become more risk averse, foundations can help to de-risk innovations. The flat or declining availability of research funding from government and industry players has left a critical need. Organizations like the Focused Ultrasound Foundation have become models for how donor funding can be used to bridge the gap between laboratory research and widespread patient treatment. Foundations are driven by the needs of patients and tasked with being good stewards of their donors’ generous contributions.

To meet their mission, foundations must ensure that their financial support leads to new patient treatments as quickly as possible. This sense of urgency is where collaboration becomes essential. If stakeholders are open to sharing their experiences, ideas and important data, the field can streamline research pathways, avoid duplication and enhance the impact of individual contributions to the field.

Open science is emerging as a methodology that facilitates collaboration by making important research products – experimental design, research data, preprints of publications – freely available as soon as possible. It has become too common in medical research to guard individual work closely, for a host of reasons, but that mentality can complicate and delay progress. A more open and collaborative culture is necessary to get to the finish line as quickly as possible. Government “big science” initiatives such as the Precision Medicine Initiative and the Cancer Moonshot have put a spotlight on promoting open science, particularly data sharing. Widespread accessibility of important data is necessary to meet their big goals – like achieving a decade’s worth of cancer progress in five years.

In addition to government, many private organizations that are passionate about driving progress, including FUSF, see open science as central to this mission and are employing open science practices and policies to govern the research projects they fund. Encouraging the use of open-access data repositories, establishing multi-site consortia to answer critical questions and making preprints of important publications widely available, among other practices and policies, will drive progress.

We are in an unprecedented position to employ collaboration to drive medical innovation beyond any foreseeable limit. Digital channels and technological advances have created a world that is constantly connected, where data from one laboratory is globally accessible in a matter of seconds. When we realize that collaboration is itself the tipping point, we can envision better care and outcomes for patients around the world.

Making the Case for Collaboration: The Essential Tremor Story

This past year brought a key turning point for the field of focused ultrasound when the FDA approved the treatment of essential tremor, marking the first use of the technology for treating the brain to be approved in the U.S. The essential tremor approval opens the door in the U.S. to the treatment of other movement disorders, as well as psychiatric disorders, using precise ablation of known targets in the brain.

After FDA approval in July 2016, the Centers for Medicare & Medicaid Services established a payment for the facility component of the procedure that went into effect this year. The next step is to approach both regional Medicare intermediaries and private insurance companies to cover and reimburse the treatment, which will ultimately allow a great number of patients access to this innovative treatment.

The timeline below shows the eight-year pathway of focused ultrasound for the treatment of tremor and the Foundation’s role in its progress. Collaboration has been key to accelerating the timeline to bring this new treatment to patients as quickly as possible:

  • From the early days of this effort, the collective discussion of multiple stakeholders in workshops and meetings convened by the Foundation helped to develop the road map.
  • These early discussions identified essential tremor as a good target for focused ultrasound treatment and designed the first clinical trial.
  • Public-private partnerships between the Foundation, industry and academic institutions then enabled the funding of the pilot and pivotal clinical trials.
  • The pivotal trial involved eight prominent academic sites and brought together neurosurgeons, neurologists and their teams from around the world to assess the safety and efficacy of this therapy.
  • Engagement with patient advocacy organizations then helped to raise awareness for the new treatment as the pivotal trial recruited patients and preliminary results were published.
  • Early release and widespread accessibility of data from these important clinical trials has enabled additional trials for other brain indications as well as technical, projects to improve the focused ultrasound procedure.

Having learned valuable lessons from the essential tremor pathway, the field is branching out to treat other neurological conditions. Clinical trials are ongoing in the U.S. for Parkinson’s tremor and dyskinesia and epilepsy, and are on the horizon for OCD, depression and dystonia. With continued collaboration within the growing focused ultrasound community of researchers, clinicians, manufacturers, foundations and other stakeholders, rapid progress is expected.

FUSF pathway graphic

Jessica L. Foley, PhD, is the chief scientific officer of the Focused Ultrasound Foundation.

This blog post originally appeared as an article in the April issue of DOTmed Healthcare Business News.