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Sonodynamic therapy for adult-type diffuse gliomas: past, present, and future
Sydney E Scanlon1, Regan M Shanahan1, Othman Bin-Alamer1
1Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
Journal of Neuro-Oncology
|July 23, 2024
Summary
Sonodynamic therapy (SDT) offers a novel, less invasive approach for brain tumor treatment by using ultrasound-activated sonosensitizers to generate cell-killing reactive oxygen species (ROS). This method shows promise in preclinical and clinical studies for improving patient outcomes.
Area of Science:
- Oncology
- Biomedical Engineering
- Pharmacology
Background:
- Intra-axial brain tumors present significant challenges due to risks associated with surgical resection and limitations of the blood-brain barrier (BBB) in drug delivery.
- Focused ultrasound (FUS) and its subset, sonodynamic therapy (SDT), are emerging as innovative, less invasive strategies for brain tumor management.
- SDT employs ultrasound-activated sonosensitizers to produce reactive oxygen species (ROS), inducing tumor cell death.
Purpose of the Study:
- To review the historical development and scientific rationale of SDT for brain tumor treatment.
- To elucidate the mechanisms of action for SDT in the context of brain tumors.
- To explore the potential clinical applications and future directions of SDT in managing brain tumors.
Main Methods:
- A systematic review was performed adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Literature search and analysis focused on preclinical and clinical studies of SDT for brain tumors.
- Evaluation of sonosensitizer efficacy, FUS parameters, and BBB modulation was conducted.
Main Results:
- Preclinical data confirm the efficacy of sonosensitizers (e.g., 5-ALA, fluorescein, porphyrins, nanoparticles) with FUS for tumor therapy and BBB disruption.
- Early clinical trials indicate promising safety and efficacy, though further research is required to optimize protocols and understand adverse effects.
- Challenges include skull penetration limitations for FUS and the dynamics of BBB opening, necessitating careful consideration for clinical implementation.
Conclusions:
- Sonodynamic therapy (SDT) presents a promising advancement in the treatment of aggressive brain tumors.
- SDT offers a less invasive therapeutic option with the potential to improve patient outcomes.
- Further research into sonosensitizers, FUS parameters, and immunomodulatory effects will refine SDT's clinical utility.
