From the January 2015 issue of HealthCare Business News magazine
In general, neuromodulatory effects of focused ultrasound could potentially enable a range of diagnostic and therapeutic benefits including:
- targeting of regions in the brain for ablative procedures
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- suppressing epileptic seizures or symptoms of psychiatric disorders
- reversible nerve blocks to treat pain
- brain mapping
Preclinical studies have shown that the mechanical and thermal effects of focused ultrasound can reversibly suppress or stimulate the function of targeted neurons. This enables the temporary blocking or activation of neural signals from targeted locations within the brain or spinal/peripheral nerves. Such techniques hold promise in the treatment of epilepsy or chronic pain (suppression) or for precise brain mapping or treatment targeting (stimulation).
Exciting the immune system to fight cancer
The field of cancer immunotherapy is progressing rapidly, with more than 25 FDA-approved drugs now available for the treatment of a range of cancers. Unfortunately, most of these therapies are effective in only around 15 to 20 percent of patients. There are many potential reasons for this modest success.
Some studies have demonstrated that immunotherapies are more effective when there is already a baseline immune response to the targeted antigen prior to treatment. What could be done to illicit this baseline response?
Ablative therapies - radiation, radiofrequency, cryo, laser, focused ultrasound - have all shown the ability to incite an immune response in preclinical and clinical studies. Ablation can awaken the tumor cells' natural defenses and increase the immunogenicity of the tumor. Some therapies such as radiation have been successful when used in combination with an immunotherapy, as a "kick start" to the immune response.
Although not yet demonstrated clinically, focused ultrasound could potentially be effective in combination with an immunotherapy. In addition to inciting the immune response, focused ultrasound could also decrease the level of immune system suppressor cells so the immune response is more robust. Focused ultrasound could be more optimal for this combination therapy than other ablative modalities given its non-invasiveness, use of non-ionizing radiation, and precision.
Furthermore, many preclinical and clinical studies have demonstrated that both the thermal and mechanical effects of focused ultrasound can illicit an immune response that in preclinical studies has led to enhanced overall survival and protection from growth of new tumors when re-challenged. This research suggests that FUS could provide benefit even as a stand-alone therapy for some patients. The recent advances in both cancer immunotherapy and focused ultrasound - whether alone or in combination - could enable powerful new approaches for the treatment of metastatic cancer. Plans are underway for a clinical trial of focused ultrasound coupled with immunotherapy for the treatment of metastatic breast cancer.
