Focused ultrasound is a noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with neuroblastoma. This novel technology focuses beams of ultrasonic energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue.<\/p>\n\n\n\n
How it Works<\/strong> One mechanism is the precise ablation (thermal destruction of tissue), which can be done to completely destroy the target or to partially treat it. Partial treatment is believed to stimulate the patient\u2019s immune response, which may have a broader impact.<\/p>\n\n\n\n Another mechanism is to produce local hyperthermia of the targeted tissue, which can have a variety of beneficial effects including the release of chemotherapy drugs that are contained in temperature sensitive molecules. This allows delivery of a higher level of chemotherapy precisely to the targeted tissue, while limiting the effects for the rest of the body.<\/p>\n\n\n\n Advantages<\/strong> For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications at a lower cost. <\/p>\n\n\n\n Potential advantages as compared to current treatments:<\/p>\n\n\n\n A clinical trial<\/strong><\/a> using thermosenstitive doxorubicin in a variety of tumors, including neuroblastoma has been completed.\u202f <\/p>\n\n\n\n The Foundation updates these pages regularly, but with the increasing number of clinical trials, we want to be sure that our audience has the latest information available. Therefore, we also added the website search information for the above trials. If you click here<\/strong><\/a>, it will take you to the latest information available from https:\/\/www.clinicaltrials.gov\/<\/strong><\/a>.\u202f\u202f\u00a0<\/p>\n\n\n\n Focused ultrasound treatment for neuroblastoma is not yet approved by regulatory bodies or covered by medical insurance companies.<\/p>\n\n\n\n Early-stage preclinical studies suggest that focused ultrasound may play a beneficial role in the treatment of unresectable neuroblastoma. In one study, mice with neuroblastoma were treated with chemotherapy, focused ultrasound plus chemotherapy, or focused ultrasound alone. Following treatment, 53% of mice treated with focused ultrasound and 80% of mice treated with focused ultrasound plus chemotherapy were cured with no evidence of tumor at 200 days, versus 100% fatality at 45 days in the control group and in mice treated with just chemotherapy.<\/p>\n\n\n\n Children\u2019s Neuroblastoma Cancer Foundation<\/strong><\/a><\/p>\n\n\n\n Sundland RM, Ballan D, Callier KM, Ayemoba J, Bellary A, Iwanicki IJ, Wu LL, Larkins T, Flores-Guzman F, Gomez-Villa J, Wyles G, Feshitan J, Kandel JJ, Sirsi SR, Hernandez SL. Sonopermeation With Size-sorted Microbubbles Synergistically Increases Survival and Enhances Tumor Apoptosis With L-DOX by Increasing Vascular Permeability and Perfusion in Neuroblastoma Xenografts<\/strong><\/a>. Ultrasound Med Biol. 2024 Nov 23:S0301-5629(24)00410-1. doi: 10.1016\/j.ultrasmedbio.2024.10.014. PMID: 39581819 <\/p>\n\n\n\n Bellary A, Nowak C, Iwanicki I, Flores-Guzman F, Wu L, Kandel JJ, Laetsch TW, Bleris L, Hernandez SL, Sirsi SR. Non-viral nitric oxide-based gene therapy improves perfusion and liposomal doxorubicin sonopermeation in neuroblastoma models<\/strong><\/a>. Theranostics. 2023 Jun 4;13(10):3402-3418. doi: 10.7150\/thno.81700. eCollection 2023. PMID: 37351172 <\/p>\n\n\n\n Bellary A, Villarreal A, Eslami R, Undseth QJ, Lec B, Defnet AM, Bagrodia N, Kandel JJ, Borden MA, Shaikh S, Chopra R, Laetsch TW, Delaney LJ, Shaw CM, Eisenbrey JR, Hernandez SL, Sirsi SR. Perfusion-guided sonopermeation of neuroblastoma: a novel strategy for monitoring and predicting liposomal doxorubicin uptake in vivo<\/strong><\/a>. Theranostics. 2020 Jul 9;10(18):8143-8161. doi: 10.7150\/thno.45903. eCollection 2020.<\/p>\n\n\n\n Eranki A, Srinivasan P, Ries M, Kim A, Lazarski CA, Rossi CT, Khokhlova TD, Wilson E, Knoblach S, Sharma KV, Wood BJ, Moonen C, Sandler AD, Kim PCW. High Intensity Focused Ultrasound (HIFU) Triggers Immune Sensitization of Refractory Murine Neuroblastoma to Checkpoint Inhibitor Therapy<\/strong><\/a>. Clin Cancer Res. 2019 Oct 15. pii: clincanres.1604.2019. doi: 10.1158\/1078-0432.CCR-19-1604.<\/p>\n\n\n\n Tung S, Fahy AS, Lamberti-Pasculli M, Waspe AC, Pichardo S, Gerstle JT.\u00a0Magnetic Resonance-guided High-intensity Focused Ultrasound(MRgHIFU) Virtual Treatment Planning for Abdominal Neuroblastoma Utilizing Retrospective Diagnostic 3D CT Images<\/strong><\/a>. J Pediatr Hematol Oncol. 2019 Jul 26. doi: 10.1097\/MPH.0000000000001563.<\/p>\n\n\n\n
Where the beams converge, focused ultrasound produces several therapeutic effects that are being evaluated.<\/p>\n\n\n\n
The mainstay of treatment for neuroblastoma is surgical resection coupled with chemotherapy. However, many patients do not respond adequately to chemotherapy and commonly relapse. Furthermore, most long-term survivors suffer adverse effects from their treatment. <\/p>\n\n\n\n\n
Clinical Trials<\/h2>\n\n\n\n
Regulatory Approval and Reimbursement<\/h2>\n\n\n\n
Preclinical Laboratory Studies<\/h2>\n\n\n\n
Additional Information<\/h2>\n\n\n\n
Notable Papers<\/h2>\n\n\n\n