The First International Experience with Histotripsy: A Safety Analysis of 230 Cases

Journal of Gastrointestinal Surgery, Год журнала: 2025, Номер unknown, С. 102000 - 102000

Опубликована: Фев. 1, 2025

Histotripsy is a novel, non-invasive, non-ionizing, non-thermal approach using focused ultrasound waves to treat liver tumors. The technology received FDA De Novo grant in late 2023. We aim provide the first reporting of post-trial, real-world clinical safety data. Safety outcomes within 30 days histotripsy were collected since clearance (12/22/2023 - 7/25/2024). All centers who have performed invited participate. Complications requiring treatment graded Clavien-Dindo and Comprehensive Index (CCI). In total, 295 patients 510 tumors at 18 centers. Treated tumor types included colorectal metastases (n=140), neuroendocrine (n=46), hepatocellular carcinoma (n=31), pancreas (n=30), breast (n=26). most common number treated per procedure 1 (n=170), 2 (n=69), 3 (n=37). Tumors all 8 segments. data was available for 230 from 9 A total 12 out experienced complications any grade (5.2%). Most (n=9, 75%) minor (< Grade II). Median mean CCI 0 (IQR 0-0) points (95%CI 0-0.75). three major (>Clavien-Dindo II, 1.3%) death disease progression. these had undergone with palliative intent known advanced intra- extrahepatic disease. This report on therapeutic use well tolerated few overall rare serious indicating profile which compares favorably other liver-directed surgical therapies Long-term follow-up including oncologic are being collected.

Язык: Английский

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Precision oncology: The role of minimally-invasive ablation therapy in the management of solid organ tumors

World Journal of Radiology, Год журнала: 2025, Номер 17(1)

Опубликована: Янв. 21, 2025

Solid organ tumors present a significant healthcare challenge, both economically and logistically, due to their high incidence treatment complexity. In 2023, out of the 1.9 million new cancer cases in United States, over 73% were solid tumors. Ablative therapies offer minimally invasive solutions for malignant tissue destruction situ , often with reduced cost morbidity compared surgical resection. This review examines current Food Drug Administration-approved locoregional ablative (radiofrequency, microwave, cryogenic, high-intensity focused ultrasound, histotripsy) evolving role care. Data collected through comprehensive survey PubMed-indexed literature on tumor ablation techniques, clinical indications, outcomes. Over time, emerging data will help establish these as standard care treatment, supported by improved long-term outcomes progression-free survival.

Язык: Английский

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Focused Ultrasound as Targeted Therapy for Colorectal Cancer: A Comprehensive Review

Gastrointestinal Disorders, Год журнала: 2024, Номер 6(2), С. 380 - 401

Опубликована: Апрель 13, 2024

Traditional cancer treatments have not significantly improved the survival rates for individuals with colorectal cancer. As a result, there is dire need to explore novel treatment modalities that can target cancer-specific niches, transform cold tumors into hot ones, and disrupt tumor niche. Therapeutic focused ultrasound, recognized its capacity induce thermal mechanical impacts on tissue, potentially eliminate cells elicit body’s anticancer reaction by disrupting microenvironment. This article provides an overview of recent developments in employing therapeutic ultrasound (TFUS) enhance natural defenses against cancers. It also discusses studies examining utility TFUS treating patients research indicating potential stimulate response various vitro vivo models. Furthermore, it explores effects immune system highlights safety effectiveness managing cancer, providing relief from pain, improving rates. Given indications may bolster augment therapy clinical preclinical models, has emerge as pivotal tool settings.

Язык: Английский

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Ultrasound-Guided Histotripsy Triggers the Release of Tumor-Associated Antigens from Breast Cancers

Cancers, Год журнала: 2025, Номер 17(2), С. 183 - 183

Опубликована: Янв. 8, 2025

Background/Objectives: There is increasing evidence to indicate that histotripsy treatment can enhance the host anti-tumor immune responses both locally at targeting tumor site as well systemically from abscopal effects. Histotripsy a non-invasive ultrasound ablation technology mechanically disrupts target tissue via cavitation. A key factor contributing histotripsy-induced effects believed be release of tumor-specific antigens (TSAs) or tumor-associated (TAAs) induce systemic response. In this study, we studied effect on HER2, well-defined TAA for cancer immunotherapy. Methods: range doses administered HER2-postive mammary cells in an vitro cell culture system and ex vivo were applied. addition, single dose was used murine model. The released proteins, specifically cell-free supernatants pellets analyzed by BCA protein assay, ultra-performance liquid chromatography (UPLC) Western blot. Results: Our results showed could significantly trigger HER2 proteins current study. level actually higher than pellets, suggesting intracellular domain into extracellular compartment. Furthermore, proportionally more doses, indicating free histotripsy-dose-dependent. Conclusions: conclusion, have qualitatively quantitatively demonstrated triggers histotripsy-mediated provides important insights mechanism underlying its immunostimulation suggests potential TSA/TAA-based immunotherapies numerous types.

Язык: Английский

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Study of Histotripsy With Subsequent Heating on In Vitro VX2 Cancer Cells

Journal of Ultrasound in Medicine, Год журнала: 2025, Номер unknown

Опубликована: Янв. 22, 2025

Objective Focused ultrasound has emerged as a precise and minimally invasive modality for effective cancer treatment. In this study, we propose novel method that integrates the mechanical effects of focused ultrasound, known histotripsy, with heating to enhance both immediate sustained cytotoxic on cells. Methods Our investigation VX2 cells in suspension, examining five experimental groups: blank control, negative alone, histotripsy subsequent heating. B‐mode imaging was utilized visualize cavitation bubble cloud formation its motion during histotripsy. The suspension contained individually sealed compartments obtained from wrap (referred compartments) embedded within agarose phantom. Residual living were examined immediately after treatment cultured 96 hours analyze growth patterns. Additionally, CFDA SE staining employed assess cell proliferation. Furthermore, intracellular extracellular heat shock protein 70 (HSP70) levels measured investigate potential initiation an immune response. Results combination significantly reduced normalized concentration It also decreased proliferation rate residual compared other groups. Histotripsy increased generation release HSP70, which might potentially innate anti‐tumor response vivo. Conclusion improved lethal impact curtailed suspension. This study presents promising strategy therapy future.

Язык: Английский

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Histotripsy of Liver Tumors: Patient Selection, Ethical Discussions, and How We Do It

Cancers, Год журнала: 2025, Номер 17(7), С. 1100 - 1100

Опубликована: Март 25, 2025

Liver malignancies, both primary and metastatic tumors, are a major cause of cancer-related mortality. Colorectal cancer alone results in liver metastases nearly 50% patients, with approximately 85% presenting unresectable disease. Similarly, hepatocellular carcinoma intrahepatic cholangiocarcinoma frequently present at advanced stages, limiting curative options. Systemic therapies provide modest survival benefits, underscoring the need for alternative treatments. Locoregional approaches, such as thermal ablation chemoembolization, while effective, have notable limitations, including invasiveness, peri-procedural risks, requirement to interrupt systemic Histotripsy is novel, non-invasive method that uses focused ultrasound-induced cavitation enable precise tumor without heat or radiation. Our institution utilizes multidisciplinary board approach evaluate patients histotripsy, particularly cases involving disease, complex surgical candidacy, palliative intent related disease control symptom management, bridging therapy transplantation. Early results, preclinical data THERESA #HOPE4LIVER trials, highlight its efficacy treating tumors minimal complications. This review outlines institutional protocols covering pre- post-procedural along ethical considerations current treatment paradigms. As patient-centered approach, histotripsy offers novel option favorable safety profile compatibility therapies.

Язык: Английский

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Cytotoxic and Cellular Response of Doped Nb-NTO Nanoparticles Functionalized with Mentha arvensis and Mucuna pruriens Extracts on MDA-MB-231 Breast Cancer Cells

Applied Biochemistry and Biotechnology, Год журнала: 2025, Номер unknown

Опубликована: Апрель 3, 2025

Язык: Английский

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The art of histotripsy: a focused ultrasound application that has the potential to treat from head to toe!

International Journal of Hyperthermia, Год журнала: 2024, Номер 41(1)

Опубликована: Фев. 7, 2024

Язык: Английский

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Abscopal Effect with Liver-Directed Therapy: A Review of the Current Literature and Future Directions

Livers, Год журнала: 2024, Номер 4(4), С. 601 - 614

Опубликована: Ноя. 22, 2024

The liver is a common site for metastatic disease. In select patients with isolated metastases, surgical resection improves survival and may be potentially curative in favorable “tumor biology”. However, when not feasible, liver-directed therapies (LDTs) can also improve outcomes, including survival, the appropriate clinical situations. LDTs, hepatic artery infusion, radioembolization, radiation, ablation techniques, such as thermal histotripsy, offer local control potential systemic effects, abscopal effect. effect occurs nontargeted, nontreated tumors regress following localized therapy to other tumors. Preclinical studies suggest that antigen-induced upregulation of key immune regulators plays central role this process. Unfortunately, reports LDT are exceedingly rare. noninvasive, nonionizing, nonthermal technique, induce an more frequently robustly than LDTs. Histotripsy enhances tumor immunogenicity through precise acoustic cavitation better preserves tissue architecture while increasing antigen release, resulting robust response. Ongoing trials investigating these immunogenic mechanisms ability generate reliably adjuncts checkpoint inhibitors. This work has significant implications regarding management metastasis.

Язык: Английский

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Advanced approaches to loco-regional and surgical management for hepatocellular carcinoma

Journal of Gastrointestinal Oncology, Год журнала: 2024, Номер 15(6), С. 2739 - 2742

Опубликована: Дек. 1, 2024

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