It is fitting to note that September is Prostate Cancer Awareness Month. Developing treatments for prostate cancer that are safe, effective and have no debilitating side effects is one of modern medicine's most elusive "holy grails."
According to the World Health Organization, an estimated 900,000 new cases of prostate cancer are diagnosed globally each year. More prevalent in developed countries, the disease afflicts Americans at the highest rate of all.
Thanks to the widespread use of PSA testing, early detection and treatment of prostate cancer has become commonplace, and the ranks of long-term survivors are growing. Unfortunately, there is a downside to these advances: today's most widely used therapies destroy both prostate tumors and surrounding nerve bundles, causing incontinency and impotency in many patients.
The long-sought solution to this "survive but don't thrive" dilemma may lie in noninvasive focused ultrasound and its ability to precisely target and destroy diseased tissue without damaging adjacent structures. So far, ultrasound-guided focused ultrasound treatments - which are only available outside the U.S. - are proving effective and non-debilitating. Many believe that even better outcomes will be achieved by focused ultrasound procedures performed under MR-guidance.
As reported in this issue, the first human clinical trial evaluating MR-guided focused ultrasound as a therapy for prostate cancer is underway, with seven patients treated to date. This is an exciting development for the field of MR-guided focused ultrasound and for prostate cancer patients worldwide. Stay tuned for study updates in future issues of this newsletter.
Before closing, it's important to note that prostate cancer will be a key topic at next month's 2nd International Symposium on MR-guided Focused Ultrasound. Leading researchers and clinicians will report the latest progress on many fronts, including prostate cancer. Within coming weeks, a list of presentations and abstracts will be posted on the Foundation website.
Important symposium reminder: Deadline for discounted hotel reservations is September 27
September 27 is the last day that attendees of the 2nd International Symposium on MR-guided Focused Ultrasound can make room reservations at the Westfields Marriott for a discounted rate. The special rate is $172 per night. Reservations made after September 27 will be billed at normal hotel rates. Make your hotel reservation by clicking here.
Abstract submissions exceed expectations, indicate where R&D is most robust
Joy Polefone, Ph.D., Scientific Program Committee secretary for the upcoming 2nd International Symposium on MR-guided Focused Ultrasound reports that 114 abstracts have been received for consideration. "The number far exceeds expectations, and indicates the robust state of research and development in this emerging field," she says.
Polefone says that abstract reviews are nearing completion and that acceptance notifications will be issued by mid-September.
This year's abstract total is nearly three times greater than submissions to the 1st International Symposium on MR-guided Focused Ultrasound, held in 2008.
Not surprisingly, one of the largest groups of abstracts address uterine fibroids, the first internationally approved indication for MR-guided focused ultrasound. "What's particularly interesting," says Polefone, "is the rank-ordering of therapeutic areas addressed by abstracts. It sheds additional light on where R&D emphasis is being placed today and where the field appears to be headed."
Foundation will announce Young Investigator Award winners this month
Eighteen early career researchers have applied for the Young Investigator Awards to be presented by the Foundation in conjunction with the 2nd International Symposium on MR-guided Focused Ultrasound.
The awards aim to encourage quality research by graduate students, research fellows, clinical fellows and junior faculty members and support them in presenting meritorious papers at the symposium. In addition to special recognition during the symposium, award recipients will receive free registration and up to $1,000 for travel and lodging expenses.
The award application process closed on September 6. Recipients will be notified in late September and will receive funding following the submission of receipts to the Focused Ultrasound Surgery Foundation.
"We've spent three years conducting site surveys and assembling these lists. We are always seeking updates. Please let me know if there is a research project, investigator or site you don't see listed," says CRN director Heather Huff-Simonin. "I also look forward to receiving updates regarding your recent activity in the field of MR-guided focused ultrasound."
Donor designates $100K to R&D for new prostate treatments
Foundation Chairman Neal Kassel, M.D., has announced the receipt of a $100,000 donation from the Herndon Foundation that will be designated to developing MR-guided focused ultrasound treatments for prostate cancer.
A spokesman for the Herndon Foundation said, "The mission of the Focused Ultrasound Surgery Foundation is in alignment with our interest in supporting the development of new, effective and less debilitating treatments for prostate cancer. We hope our gift ultimately helps improve the prognosis and quality of life for millions of prostate cancer patients worldwide."
"We are very appreciative of this generous contribution," Kassell said. "Noninvasive and highly precise MR-guided focused ultrasound treatments for prostate cancer are quickly moving toward clinical reality. This gift will be used to step up the pace of progress."
UCSF receives NIH grant to purchase MR-guided FUS system
The University of California San Francisco (UCSF) will soon install a MR-guided focused ultrasound system thanks to a $1,368,750 grant received from the National Institutes of Health.
Principal investigator for the project is Fergus Coakley, M.D., Professor of Radiology, Abdominal Imaging Section Chief, and Vice Chair of Clinical Service at UCSF. He says that the grant will cover capital costs of equipment and that due diligence is now in progress regarding system selection.
When the equipment is up and running, Coakley and his interdepartmental colleagues plan to explore new applications of MR-guided focused ultrasound such as treatments for painful bone metastases and prostate cancer. "We're looking to push the envelope and do what we can to advance this exciting field," he says.
First prostate cancer patients treated with MR-guided focused ultrasound
Two medical centers in Russia and Singapore have begun using noninvasive MR-guided focused ultrasound to treat patients with localized low-risk prostate cancer. The procedures are being performed as part of a clinical trial that is expected to include other sites around the world.
In an announcement last month, InSightec said that physicians at the N.N. Petrov Research Institute of Oncology in Saint Petersburg, Russia and at the National Cancer Centre at the Singapore General Hospital, Singapore have so far treated seven men in a Phase 1 clinical trial using its ExAblate system.
"We have had excellent results with ExAblate in treating patients suffering from bone metastases and we believe it has tremendous potential in treating prostate cancer patients with a low complication rate. We and our patients have been very pleased with the results achieved to date," said Professor S.V. Kanaev, Chairman of Radiation Oncology at the N.N Petrov Research Institute of Oncology who is serving as principal investigator for the study.
At Singapore General Hospital, Associate Professor Christopher Cheng, Head and Senior Consultant in the Department of Urology, observed, "Current treatment options for low risk prostate cancer patients have shown limited success in preserving potency and continence functions. We believe that, with the ExAblate non-invasive procedure, we stand a better chance of minimizing life time morbidity without compromising life expectancy."
At present, approved treatment options for prostate cancer include prostatectomy (surgical removal of the prostate gland), radiation therapy, brachytherapy (implantation of radioactive seeds), and cryotherapy. Outside the U.S., ultrasound guided high intensity focused ultrasound (HIFU) is also a treatment option.
Start-up firm, FUS Instruments, offers turnkey system for preclinical research
A commercial spin-off of the pioneering Focused Ultrasound Laboratory at Sunnybrook Health Sciences Centre (SHSC) in Toronto is offering a complete image-guided focused ultrasound system for preclinical research.
"The company's goal is to lower the technology barrier that has made it difficult to evaluate the safety of therapeutic uses of focused ultrasound prior to translation into humans," explains Rajiv Chopra, Ph.D., an imaging research scientist at SHSC who serves as interim president of the new venture, FUS Instruments, Inc.
Designed to fit within the bore of a clinical magnetic resonance imager (MRI) or x-ray computed tomography (CT) scanner, the company's computer-controlled focused ultrasound system is completely non-magnetic and consists of a high powered ultrasound transducer and a three-axis positioner. Custom-built and calibrated, the transducer is capable of exposing millimeter-size volumes of tissue. The highly precise positioning system can translate the transducer along arbitrary 3D paths during imaging.
Chopra says the system can deliver exposures ranging from high-power continuous sonications for thermal coagulation of soft tissues to pulsed sonications suitable for applications such as tissue lysis, drug delivery or vascular permeabilization. Real-time monitoring of forward and reflected electrical power to the transducer enables consistent delivery of energy during experiments.
"We've designed the system to be flexible, so users can design their experiments to suit their needs," Chopra explains. "It can be used on all MR systems from the major vendors at both 1.5 and 3.0T and can be set up in under ten minutes."
He adds, "Completely portable between the laboratory and the MR scanner, the system requires no modification of existing magnet rooms for proper function. In addition, FUS Instruments offers the accessories and peripheral equipment necessary to engage in this exciting area of medical research."
To retain its cutting edge perspective, FUS Instruments is working in partnership with SHSC scientists in developing preclinical systems for focused ultrasound. More information about the company can be found at fusinstruments.com or by visiting booth #7356 at the upcoming RSNA meeting in Chicago.