The 95% success rate far exceeded expectations

Michigan Medicine recently announced a groundbreaking advancement in liver cancer treatment: “histotripsy,” which uses targeted ultrasound waves to break down tumors.

The results were published in Radiology and supported early clinical adoption of the procedure.

The #HOPE4LIVER trial, which began in 2021, tested the safety and efficacy of histotripsy in patients with primary and metastatic liver tumors. With a 95% success rate, the trial exceeded expectations and confirmed histotripsy as a highly effective and safe treatment option. In addition to its high success rate, the trial reported a low complication rate of only 7%, which is comparable to or better than other local treatments for liver cancer.

The trial involved 44 participants with 49 tumors. The treatment successfully worked in 42 of the 44 patients, surpassing the 70% performance target. Only three cases reported significant complications related to the procedure, well under the 25% safety threshold. Additionally, two of these complications are thought to be linked to the cancer itself rather than the device.

Pioneered at the University of Michigan (U-M), this technology offers a promising alternative to traditional cancer treatments, such as surgery, radiation, and chemotherapy, which often come with significant side effects. Histotripsy received FDA approval in late 2023 as an alternative to traditional forms of liver cancer treatments.

U-M engineers and physicians developed histotripsy over two decades ago, and the recent trial marks a significant milestone in the fight against liver cancer. The company behind the technology, HistoSonics, now has clearance to market its histotripsy platform, Edison, for the treatment of liver cancer.

This platform is designed to deliver focused ultrasound waves that create microbubbles within the tumor. As these bubbles form and collapse, they destroy the tumor cells while leaving healthy tissue unharmed. This process also triggers the body’s immune system to clean up the debris and potentially even learn to target other cancer cells.

This breakthrough offers hope to the many patients who suffer from liver cancer, particularly those whose cancer has spread from the colon. Historically, treatment options for liver tumors have included invasive surgeries, thermal ablation, and radiation, all of which come with risks and lengthy recovery times. By contrast, histotripsy is entirely non-invasive, which means patients can avoid the physical strain of surgery or the adverse side effects of chemotherapy and radiation.

One of the most exciting aspects of histotripsy is its potential to revolutionize cancer treatment beyond the liver. Researchers are exploring ways to combine histotripsy with immunotherapy or drug delivery, which could transform it from a localized treatment into a global one that targets tumors throughout the body. In preclinical studies, histotripsy not only destroyed liver tumors but also triggered the immune system to recognize and attack cancer cells, reducing the chance of recurrence.