Focused Ultrasound and Cancer Immunotherapy: A Field on the Rise

Written by Jessica Foley, PhD

In 2015, the Foundation launched a Cancer Immunotherapy Program to explore the impact of combination approaches using focused ultrasound plus immunotherapy on a variety of cancers. During the intervening years, research in the field of focused ultrasound immuno-oncology (FUS-IO) has grown rapidly.  

Recognizing this surge of research, the Foundation released a landscape analysis of FUS-IO in April, assessing where the field stands with respect to the initial burning questions that have guided our work to date. This blog provides a Q&A style overview of the FUS-IO landscape analysis, its path forward, and the Foundation’s role.  

What is the purpose of this landscape analysis? 
The burning questions were conceptualized at the Foundation’s June 2019 CI Workshop. During that meeting, the leading minds in the field identified a short list of questions that would guide future research around the use of focused ultrasound in cancer immunotherapy applications.  

Now, four years later, we wanted to revisit these questions and explore how research has addressed, answered, or raised further questions. The purpose is to see where we are and to aid discussions on where we should go now. We hope to get some clarification on that at future FUS-IO workshops.  

What surprised you most in the findings? 
I wouldn’t say it was surprising, but one of the most important findings was that there are few straightforward answers. For instance, many variables should be considered when predicting treatment response and choosing optimal treatment regimen, including focused ultrasound parameters, tumor characteristics, and drug choice. There needs to be room for multi-factor decision making. In fact, we found that attempting to answer the questions led to more questions.  

What is the most exciting thing in focused ultrasound and cancer immunotherapy right now? 
One of the biggest areas of research that has emerged lately is the role of focused ultrasound in combination with cellular therapies, such as chimeric antigen receptor T (CAR-T) cells. There has been a lot of active research using these genetically modified T cells to treat blood cancer, but they have been less successful for solid tumors. I’m excited to learn how focused ultrasound could be helpful, especially in enhancing drug delivery. 

How is the Foundation advancing the field of cancer immunotherapy? 
Establishing the Foundation’s Cancer Immunotherapy Program has been by far the most important contribution we’ve made to the larger field. We launched the program in 2015 with our first workshop. Our collaborative community is working together to identify the big questions and move things forward to advance the field. In the early workshops, there was a sense of hesitancy to jump into discussion and share ideas, but that had changed by the last workshop we held in September 2021. I was pleasantly surprised by the attendees’ openness to share data that had not been published, preclinical research, and even clinical trial design suggestions. With increased collaboration comes a decrease in redundant research, which helps push the field forward.  

What are the key partnerships that have helped the Foundation to advance the field? 
We have several important partners – from field-specific organizations to research sites – but our crucial partner in advancing the FUS-IO field has been the Cancer Research Institute (CRI). CRI helped host our first workshop and each one since. They have helped to connect us with so many in the immunology and immunotherapy fields – people who were unaware of focused ultrasound. CRI’s involvement has helped validate focused ultrasound as a promising technology for the cancer immunotherapy field, and we would not be as far along as we are without their expertise. 

Last year, we also realized a momentous partnership with the University of Virginia in establishing the Focused Ultrasound Cancer Immunotherapy Center. This is the world’s first center dedicated specifically to advancing a focused ultrasound and cancer immunotherapy treatment approach. 

What is next for the Foundation and CI? 
Four years ago, our biggest concern was that there are many different ways to use focused ultrasound and we needed to understand what effect they all have on the immune system. That was a preclinical question, and we’ve come a long way in the field since then. Now, we are looking at how these various focused ultrasound “modes” inform clinical translation. There are ongoing clinical trials using the technology for thermal ablation, histotripsy, and drug delivery, and these early trials will also inform future research questions. Ultimately, we may need to develop a multi-factor tool to tailor focused ultrasound immunotherapy for specific patients. We have crossed the threshold of questioning whether a combination approach will be useful. Now the aim is to optimize its use and realize the benefits.  

See the FUS-IO Landscape Analysis

Jessica Foley, PhD, is the Foundation’s Chief Scientific Officer and Managing Director, Cancer Immunotherapy Program and Government Affairs.