First FDA approved experience with histotripsy for liver cancer management

Area of Science:

• Oncology
• Medical Physics
• Gastroenterology

Background:

• Histotripsy is a novel, non-invasive focused ultrasound therapy utilizing mechanical disruption via cavitation.
• It offers a precise, non-thermal alternative to conventional liver cancer treatments, preserving vital vascular and biliary structures.
• Limited data exists on early histotripsy applications for primary and secondary liver tumors.

Purpose of the Study:

• To evaluate the early efficacy and safety of histotripsy in treating primary and secondary liver tumors.
• To assess short-term disease control and patient outcomes following histotripsy treatment.
• To explore histotripsy's potential for downstaging or bridging patients for resection or transplantation.

Main Methods:

• Retrospective analysis of 27 patients treated with histotripsy for liver tumors.
• Evaluation of treatment response using computed tomography (CT) scans within three months post-procedure.
• Categorization of patients into downstaging/bridging intent (9) and palliative intent (18) groups.

Main Results:

• In the downstaging/bridging group, 87.5% of evaluable patients showed no lesion growth within 3 months.
• In the palliative group, 33% had controlled tumor growth, while 67% experienced progression.
• Four patients experienced decreased tumor size in non-histotripsy-targeted lesions; three were downstaged for resection, and five became eligible for transplantation.

Conclusions:

• Histotripsy demonstrates significant potential for liver tumor treatment, achieving high short-term local disease control.
• It offers advantages over thermal therapies by preserving vascular and biliary structures.
• Further investigation into abscopal effects and combination therapies is warranted for advanced liver disease management.