Pancreatic cancer continues to be a devastating disease, with an overall 5-year survival rate of around 13%. Accounting for about 3% of all cancers, it is the third leading cause of cancer death in the United States. Difficulties in diagnosis–due to the anatomic location of the pancreas and patients being asymptomatic or having ambiguous symptoms in early stages–cause treatment options to be limited. Surgical resection, chemotherapy, radiotherapy, and other interventions present significant challenges, prompting researchers to continue to seek new alternatives.  

Non-Invasive Pancreas Ablation Using Histotripsy: Pre-Clinical Safety Study in an In Vivo Porcine Model¹

Histotripsy has emerged as a new noninvasive modality for cancer ablation and is currently approved by the US Food and Drug Administration for the treatment of liver tumors. A collaborative international group of researchers based at Virginia Tech and led by Eli Vlaisavljevich, PhD, recently published a preclinical feasibility study to further determine whether histotripsy could become a possibility for treating pancreatic cancer.  

The group used Virginia Tech’s in vivo porcine model to evaluate the safety profile of pancreatic histotripsy. Histosonics provided a clinical histotripsy system for use in the study, which is guided by ultrasound imaging. This clinical system’s telescoping coaxial imaging probe allows the radiologist to visualize and target the pancreas. Nine pigs were treated and then observed for either 1 week (n=3) or 5 weeks (n=6) and monitored for any side effects or reactions to the treatment. The researchers found the histotripsy procedure to be well tolerated, and they were successful in targeting the pancreas in most (six of nine) of the patients.  

Post-procedure, the histotripsy lesions were immediately visualized with CT scans and aligned with the planned treatment volume. Major arteries and veins were found to be preserved, highlighting histotripsy’s tissue selectivity. At five weeks post-treatment, researchers observed that the lesion size had been reduced. They also found some side effects, noting two potential cases of pancreatitis (inflammation of the pancreas) and three patients with bowel damage. The group highlighted the importance of improving organ visualization and targeting to avoid these complications.  

“I lost my father to pancreatic cancer seven months after his diagnosis, and what struck me most was how little the standard of care had changed from the treatment his own father received decades earlier. That reality has stayed with me and continues to drive my work. I believe histotripsy can fundamentally change how we treat pancreatic cancer, whether as a stand-alone therapy or in combination with existing treatments. Because every extra year matters,” shares lead author Jessica Gannon, a National Science Foundation Graduate Research Fellow.  

The publication concluded that histotripsy is a viable technology for reaching the pancreas, so it may provide a promising noninvasive alternative for the treatment pancreatic cancer. These results represent an important step toward clinical translation.  

This work was supported by Histosonics, Inc, the Virginia-Maryland College of Veterinary Medicine, the Virginia Tech Institute for Critical Technology and Applied Sciences Center for Engineered Health, several grants from National Institutes of Health, and the Focused Ultrasound Foundation. 

Reference:

1) https://www.sciencedirect.com/science/article/pii/S0301562925002959

(Newswisw/HG)