The Foundation has launched a new blog to share commentary on the latest developments in the FUS field and to communicate important information with our key audiences. You can find the blog on our website, on Medium, and we will send notice of new blog posts via social media, email, and this newsletter. Our first blog entry, written by founder and chairman Neal F. Kassell, MD, discusses Senator McCain’s recent diagnosis and the role of focused ultrasound in treating brain tumors.
Like many of you, all of us at the Focused Ultrasound Foundation were surprised and saddened to learn of Senator John McCain’s recent glioblastoma (GBM) diagnosis. GBM and other brain tumors are a major focus of our research here at the Foundation, and we are unfortunately all too familiar with the devastating effects of this disease on patients and their families. Our thoughts and well wishes are with the McCains, and we sincerely hope he will be one of the lucky ones to survive for many years to come.
Francesco Prada, MD, is the latest fellow to join the Foundation as a Merkin Scholar, arriving in July from the Istituto Neurologico Carlo Besta in Milan, Italy. All of the previous Merkin Scholars have been technical researchers – Dr. Prada is the Foundation’s first clinical fellow. Made possible by support from Dr. Richard Merkin, the fellowship is meant to embed an international researcher within the Foundation team and stimulate collaboration.
Dr. Chandan Guha, PhD, MBBS, Vice Chair of the Department of Radiation Oncology at the Albert Einstein College of Medicine in New York City, led a webinar hosted by the Foundation on July 24 regarding focused ultrasound and the treatment of cancer. Dr. Guha specifically discussed the state of research using FUS in combination with other therapies for producing a powerful and sustained immune response to more effectively treat cancer.
In recent years, immunotherapy has demonstrated incredible potential to treat many patients with advanced cancer. For example, we know that a class of therapies known as checkpoint inhibitors “take the brakes off” the immune response, enabling a stronger immune attack against cancer. However, despite their demonstrated benefits, checkpoint inhibitors are effective in only 20–40 percent of patients. Dr. Guha and others have demonstrated in pre-clinical laboratory models of melanoma, breast, prostate, and pancreatic cancers (among others), that using a combination approach – adding focused ultrasound and/or radiation to the immunotherapy regimen – can enhance the effectiveness of the treatment. Dr. Guha’s webinar has reached more than 2,000 people to date.
Medgadget, the online journal of emerging medical technologies, recently published an interview with the Foundation’s Chief Scientific Officer, Jessica Foley, PhD, about the use of focused ultrasound for improving cancer immunotherapy. “Focused ultrasound applied to a tumor can cause the release of tumor antigens that can awaken the immune system so it can begin to fight the tumor,” said Foley. “Promising preclinical studies in models of breast cancer, melanoma, pancreatic cancer, and glioma (among others) have demonstrated that focused ultrasound can initiate a powerful anti-tumor immune response either alone or in combination with immunotherapeutics such as checkpoint inhibitors.”
Founder and chairman of the Focused Ultrasound Foundation, Neal F. Kassell, MD, participated in an episode of the World Economic Forum’s “A Glimpse into the Future,” which was posted at the end of July. “A Glimpse into the Future” is a weekly podcast that explores how breakthrough technologies and innovative ideas are shaping the future. Host Rigas Hadzilacos talked with Dr. Kassell about focused ultrasound technology and what the Foundation is doing to advance research and development.
When asked about the future of this technology, Dr. Kassell responded, “Our vision is that in 10-15 years focused ultrasound will be a standard of care of mainstream therapy that will be used to treat literally millions of patients with serious medical disorders around the world.”
The talented group of interns participating in the sixth year of the Foundation’s summer internship program included four college students who worked on projects ranging from focused ultrasound patient registries to the use of 3D-printed lenses for transcranial FUS. They were recently able to showcase their projects during a presentation to Leigh Middleditch, who is on the Board of the Claude Moore Charitable Foundation, the generous funder of this summer program.
“This summer’s interns made valuable contributions to FUSF internal efforts on treatment planning and the adoption of affordable focused ultrasound technologies, in addition to making headway toward the development of a standards document that seeks to compare commercially-available FUS systems across a unified set of equipment specifications,” said the Foundation’s Director of Extramural Research, Matt Eames, PhD.
Neuromas can occur after nerve injury, when a damaged nerve attempts to regenerate and reconnect. They can be extremely painful and resistant to conventional pain management therapies. Patients who have had amputations are at risk for painful neuromas forming in the remaining extremity stump. Researchers at Rambam Health Care Campus in Haifa, Israel, recently began a new clinical trial to evaluate the feasibility and safety of using focused ultrasound to treat patients with chronic pain from these injuries.
“Our trial investigates the safety and technical feasibility of focused ultrasound to ablate painful neuromas in patients with amputations who suffer from pain or phantom pain in their stump,” said Elon Eisenberg, MD, Professor of Neurology and Pain Medicine at Rambam, and the study’s principal investigator. “Results will help determine whether focused ultrasound is a possible medical treatment for managing stump neuroma.”
The first patient, a 66-year-old woman with a lower leg amputation caused by a congenital venous malformation, underwent focused ultrasound treatment of phantom leg pain. One week after her treatment, she reported significant reduction in her stump pain. Insightec’s Exablate device is being used in the study.
The focused ultrasound work of Raag Airan, MD, PhD, Stanford University Assistant Professor of Radiology, has been selected as the finalist for the 2017 Science & PINS Prize for Neuromodulation. The paper, entitled “Neuromodulation with Nanoparticles,” describes using focused ultrasound to uncage nanoparticles. Dr. Airan wrote, "Focused ultrasound is a near-ideal modality for clinical noninvasive neuromodulation, because it can efficiently deliver energy at significant depth throughout the body."
The American Association of Physicists in Medicine (AAPM) held their annual meeting from July 30 through August 2 in Denver. The focused ultrasound presentations covered topics ranging from the history of cancer immunotherapy and the role FUS can play in immunomodulation; clinical case studies in the use of FUS for the treatment of bone tumors and movement disorders; and the development of new FUS devices for brain treatments. “Many of the clinicians who attended this meeting share our views on open science and collaboration,” said the Foundation’s Director of Extramural Research, Matt Eames, PhD, after attending the sessions. “I was pleased to hear how the principles that are permeating our work at the Foundation (and other medical not-for-profit organizations) are also being advocated in the medical physicist community.”
The Focused Ultrasound Foundation was a primary sponsor of the AAPM’s Ultrasound Special Program, a dedicated three-day ultrasound track at the meeting that allowed attendees hands-on experience with focused ultrasound systems and a full day of talks on each of focused ultrasound and ultrasound for guiding therapy.
Gene therapy for Parkinson’s has been shown to alter brain chemistry to restore the function of the neurons affected by this disease. Scientists at the University of Virginia and Johns Hopkins University recently completed a Foundation-funded study using focused ultrasound to deliver genes through the blood-brain barrier. Improving the effectiveness of gene therapy would be an important role for focused ultrasound technology.
This month’s research highlights include three different mechanisms of focused ultrasound: drug delivery, histotripsy, and bubble generation. Two preclinical brain studies – one for glioblastoma and one for intracranial blood clots – may offer improved treatment options. The third study describes a new way that the technology could change tumor treatment.
A small group of researchers in Germany, led by Frank Wolfram, PhD, are studying whether flooding a lung with a gas free saline-lung compound could allow the use of focused ultrasound to treat lung tumors. Their recent work centered on detecting and preventing cavitation and its potential damage in this setting. This study was co-funded by the Focused Ultrasound Foundation and SRH Waldklinikum Gera.
Earlier this month, SonaCare Medical announced that Palo Alto-based Decathlon Capital Partners would be providing $3 million to finance growth. The announcement follows the July publication by the Centers for Medicare and Medicaid Services of a reimbursement code (HCPCS code C9747) for SonaCare’s minimally-invasive focused ultrasound prostate tissue ablation procedure.
SonaCare Medical CEO Mark Carol said, “Obtaining a C-code legitimizes the important role of HIFU technology in modern-day prostate care. With the financing provided by Decathlon Capital, we can substantially increase the clinical availability of our technology.”
The Foundation congratulates Insightec for reaching an important milestone this month: the treatment of the 1,000th Exablate Neuro patient. As announced August 16, more than 30 of the systems are now installed in 10 countries worldwide and are actively treating patients for essential tremor. The technology is also being used to treat a variety of conditions under research protocols. “We are well on our way to changing the lives of millions of people living with essential tremor in the US and around the world,” said Maurice R. Ferré, MD, Insightec’s CEO and Chairman of the Board. Well done to our friends and colleagues!