FDA approves first-of-its-kind new ‘bubble’ treatment for liver cancer

Histotripsy could cause less harmful side effects compared to radiation and chemotherapy, experts say

A new treatment that could help people with liver cancer and cause less harmful side effects compared to radiation and chemotherapy can now be marketed in the US.

The treatment, called histotripsy, was developed at the University of Michigan, according to The University Record.

The treatment is sold under the name of the Edison System and, this month, received marketing authorisation from the US Food and Drug Administration (FDA), per a bulletin from the American Society of Clinical Oncology (ASCO).

“Histotripsy is an exciting new technology that, although it is in early stages of clinical use, may provide a noninvasive treatment option for patients with liver cancer,” Mishal Mendiratta-Lala, principal investigator in the clinical trial of the treatment, told The University Record. “Hopefully it can be combined with systemic therapies for a synergistic therapeutic effect.”

According to a paper published in the International Journal of Hyperthermia in 2021, histotripsy is a first-of-its-kind treatment.

During histotripsy treatment, sound waves are administered. These generate small gas bubbles within the targeted tissue, and when these bubbles pop, a shockwave that can break up a mass and kill cancerous cells is released.

Histotripsy may also be applicable for patients with kidney cancer, soft tissue tumours, and osteosarcoma, per the Focused Ultrasound Foundation.

According to the ASCO, an estimated 41,210 adults in the US will receive a diagnosis of primary liver cancer this year. The disease impacts more men than women; among those who are expected to be diagnosed, nearly 28,000 are expected to be men.

The disease has grown much more common in recent decades: Liver cancer incidence has more than tripled since 1980. Worldwide, more than 905,000 people were diagnosed with liver cancer in 2020, and it is considered the third leading cause of cancer death globally. The disease will cause an estimated 29,380 deaths in the US this year, per the ASCO.

The survival rate for liver cancer has increased with recent technologies: 40 years ago, it was only three per cent, per the ASCO. Now, the five-year relative survival rate for liver cancer is 21 per cent.

Histotripsy is exciting in part because it may be easier on patients than other cancer treatments, including radiation and chemotherapy. It may be particularly helpful for patients on a long list of medications, as it presents fewer concerns related to drug compatibility when compared to other treatment options, per The University Record.

Patients with liver cancer may benefit from a combination of histotripsy and another treatment, like immunotherapy.

“That will move histotripsy from a local therapy into one that can treat tumours globally all over the body and eventually into a cure,” Mendiratta-Lala told The University Record. “In terms of the cancer treatment, that will be the next step, and I feel very excited about the potential.”