Key Points
- Dr. Tuohy is an associate professor of surgical oncology at the Virginia-Maryland College of Veterinary Medicine.
- Learn more about her research exploring histotripsy and immunotherapy to improve outcomes for veterinary and human patients.
Joanne Tuohy, DVM, PhD, is an associate professor of surgical oncology at the Virginia-Maryland College of Veterinary Medicine. She leads the Comparative Oncology Research Laboratory at the Roanoke Virginia Tech campus, where her team works to embrace the One Health concept to improve cancer outcomes for veterinary and human patients.
We recently spoke with Dr. Tuohy about her research exploring histotripsy and immunotherapy for canine patients with bone cancer, oral tumors, liver cancer, and more.
Why did you choose veterinary medicine?
Veterinary medicine gives me the unique opportunity to care for both animals and their human families, which I find incredibly meaningful and inspiring. I’m also passionate about research, because I believe it’s through research that we can improve care for our pets and potentially benefit human medicine as well.
How did you get involved with focused ultrasound?
I found focused ultrasound after exploring ablation technologies as a less invasive alternative to surgery for treating tumors. I am a veterinary surgical oncologist, so I’ve seen both the power and limitations of surgery. The potential of focused ultrasound as a noninvasive treatment option for cancer and other diseases really drew me in.
How is focused ultrasound being used in veterinary medicine today?
The technology is still in the developmental stage and hasn’t yet become a standard treatment for most conditions. One of the most advanced applications so far is the noninvasive ablation of urinary stones, with pioneering work led by researchers like Adam Maxwell, PhD, at Virginia Tech.
Outside of that, focused ultrasound is still largely in the research phase across other areas of veterinary care. However, exciting progress is being made, and I’m hopeful we’ll soon see many of these applications become part of standard treatment options for animals.
One mechanism of focused ultrasound that you use is histotripsy. Could you explain what that is and its benefits over other approaches?
Histotripsy is a type of focused ultrasound that destroys targeted cells—such as cancer cells—using mechanical pressure rather than heat. Unlike traditional thermal ablation methods, histotripsy relies on precise acoustic energy to break down unwanted cells while avoiding damage to surrounding healthy tissues.
One major advantage is that histotripsy can be used more uniformly than thermal techniques. For example, in areas with large blood vessels, the large amount of liquid can decrease the temperature of the ablation zone and create inconsistent temperatures. Because of its non-thermal mechanism, histotripsy offers a more controlled and potentially safer alternative for tissue ablation. Histotripsy also reduces the risk of thermal damage to surrounding tissues.
One indication you are pursuing is osteosarcomas. Tell us about that work.
My collaborator, Eli Vlaisavljevich, PhD, and I are working to develop histotripsy as a treatment for osteosarcoma, a highly aggressive and painful bone cancer that affects both dogs and humans – especially children and teenagers. One of the key challenges we face is that bone, unlike soft tissues, deflects ultrasound waves, making it more difficult to accurately target tumors with this technology.
Our work focuses on refining the engineering and histotripsy parameters to overcome these challenges and successfully ablate tumors within the bone.
Our two main goals are to use histotripsy to noninvasively destroy osteosarcoma tumors within bone and to stimulate a stronger immune response against the cancer. If successful, this could lead to a nonsurgical treatment option for patients that avoids the need for amputation or extensive surgery.
Additionally, we hope to harness histotripsy’s potential as an immunostimulant, enhancing the effectiveness of immunotherapies, which so far have had limited success in treating sarcomas like osteosarcoma. We believe this combination approach holds significant promise for improving outcomes in both veterinary and human medicine.
What have you discovered so far about the immunomodulatory effects of histotripsy?
So far, our research has included both benchtop studies and preclinical models of osteosarcoma. We’ve also gathered immune response data from dogs enrolled in our histotripsy clinical trials. These combined approaches have allowed us to study how the immune system reacts to histotripsy at multiple levels.
Our findings suggest that histotripsy does indeed stimulate the immune system by activating its two main branches– the innate and adaptive branches. This immune activation may help the body better recognize and attack residual tumor cells, which is especially important for combating the spread of cancer to other organs. Since metastatic disease is a major cause of mortality in both dogs and humans with osteosarcoma, enhancing immune response through histotripsy could represent a significant advancement in treatment.
What are some of the current limitations or challenges that you face when implementing histotripsy in the veterinary setting?
One current challenge is the wide variation in patient size, from small cats to large dogs, which requires adaptable and flexible device systems. Most existing systems are designed with human patients in mind, particularly adults, making them less suitable for smaller animals. Addressing this limitation in the veterinary setting could drive innovation toward more versatile devices that are also better suited for pediatric patients.
Tell us about your current clinical trials.
One of our key studies is the one that combines histotripsy with immunotherapy for dogs with osteosarcoma in their legs, which is especially exciting. We have also begun trials for oral and liver tumors, and we’re looking forward to advancing those as well.
Recruitment has steadily improved as awareness of the trials has grown, and we’re grateful for the interest and participation from pet owners. All of our studies are listed on the Virginia Tech College of Veterinary Medicine clinical trials website, where interested families can learn more.
What are some of the most common concerns from owners who are interested in enrolling their pet in a clinical trial?
Most questions tend to focus on logistics, especially when they’re traveling from out of state—places like Florida, Illinois, or even California. Concerns often include the cost of travel and accommodations, as veterinary medicine doesn’t yet have support infrastructure like human medicine does.
In terms of the clinical trial itself, I spend time explaining what participation entails, emphasizing that we cannot guarantee individual benefit and that unexpected side effects are possible. These are essential points for any clinical trial, not just those involving histotripsy. Overall, I’ve found that most families are open and engaged, with few concerns about the technology itself. It’s usually the practical challenges that are top of mind.
Beyond cancer, how do you see focused ultrasound benefiting veterinary medicine more broadly?
Focused ultrasound’s noninvasive nature opens the door to a wide range of applications, such as the ablation of urinary stones that Dr. Maxwell is working on. This is a common and painful condition in dogs and cats. These types of non-cancer applications are greatly needed and could significantly improve animal health and quality of life, while also providing translational insights that benefit human medicine.
In addition, there is growing interest in using focused ultrasound for conditions affecting the heart and nervous system. There is interesting research into low-intensity focused ultrasound suggests potential benefits for neuromodulation and pain management. The versatility of this technology makes it a promising area for further exploration in veterinary care.
What do you wish more pet owners and veterinary professionals understood about the technology?
Focused ultrasound is a noninvasive, non-ionizing treatment option with broad potential beyond just cancer care. We are researching conditions that affect younger animals, where avoiding the long-term risks of ionizing radiation is crucial. As an emerging technology, and the possibilities are limitless.
What’s next for your team?
We plan to continue our work with histotripsy for osteosarcoma and are exploring the different combination therapies with immunotherapy while also applying this technique to other tumors. We would also like to create a hub of focused ultrasound research and work with local clinical practices and expand to other institutions and clinics in the future.
Podcast
Dr. Tuohy joins Tasha, a pet parent whose Dobermans were treated with focused ultrasound for osteosarcoma at Virginia Tech. Listen now.
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