Cancer ablation with histotripsy

Abstract

Histotripsy is an ablation method using mechanical action of cavitation bubbles to fracture cells and tissue structures as a non-invasive cancer treatment for tumor masses occurring at locations in the body with a suitable acoustic window. Non-thermal ablation modalities including histotripsy have been shown to enhance immune system stimulation with potential for anti-tumor benefit beyond the targeted volumes. This talk will give an overview of histotripsy cancer research to date treating cancer models and early clinical trials. Key areas of research include instrumentation for treating rodent models, best strategies for spatial-temporal dosing of histotripsy, and working to understand the mechanisms of immune stimulation to best take advantage of abscopal effects and adjuvants for combination therapy. We have constructed several precision histotripsy systems for targeting subcutaneous and orthotopic tumors in mice and rats using a combination of ultrasound, MRI, and stereotactic guidance. Evidence to date has shown the strongest immune stimulation occurrences with moderate cavitation doses. Histotripsy ablation studies show stimulation of tumor-specific immune responses capable of magnifying the impact of checkpoint inhibition immunotherapy.