Observed Immune Response Following Histotripsy in Metastatic Hepatocellular Carcinoma

Area of Science:

• Oncology
• Immunology
• Medical Technology

Background:

• Histotripsy is a noninvasive, nonthermal focused ultrasound therapy for tumor ablation.
• Emerging evidence suggests histotripsy can stimulate antitumor immune responses.
• This case explores histotripsy combined with systemic immunotherapy in hepatocellular carcinoma (HCC).

Purpose of the Study:

• To report a case of histotripsy combined with systemic immunotherapy in metastatic HCC.
• To investigate the potential for histotripsy to induce a systemic immune response in HCC patients.

Main Methods:

• A 63-year-old male with multifocal metastatic HCC received atezolizumab plus bevacizumab, followed by histotripsy ablation of liver lesions.
• Treatment was administered due to ineligibility for liver transplantation.
• Response was assessed via imaging post-treatment.

Main Results:

• Partial radiographic response observed in the targeted lesion.
• Partial responses noted in multiple nontarget lesions, suggesting a systemic immune effect.
• Response occurred after immunotherapy discontinuation due to toxicity.

Conclusions:

• Histotripsy combined with immunotherapy may elicit an abscopal-like immune response in metastatic HCC.
• Histotripsy could be a valuable adjunct for patients intolerant to prolonged immunotherapy.
• Further clinical trials are warranted to confirm this potential synergy.