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2024.08.28

word count: 1804, reading time: about 3 minutes

introduction: li ka-shing, a 96-year-old hong kong tycoon, "flashed" at a press conference on august 27 and called the device "incredible."

author |first financial news qian tongxin

cover image source|read special news

according to multiple media reports, 96-year-old hong kong tycoon li ka-shing "flashed" at a press conference on august 27. the li ka-shing foundation donated a breakthrough new liver cancer treatment instrument, the histotripsy device, to the li ka shing faculty of medicine of the university of hong kong (hku faculty of medicine), and called it "incredible."

li ka-shing waved his hands in his signature style with a bright smile (source: du te news)

it is reported that the instrument can use high-intensity ultrasound to accurately destroy liver cancer cells, eliminating tumors without surgery, and is a "non-invasive" device for precise cancer treatment. there are also unofficial data saying that the cure rate of liver cancer with this instrument exceeds 65%.

however, experts said that this new technology can only serve as a supplement to existing treatments such as surgery or chemotherapy, and its clinical value remains to be further explored.

the us fda has approved

currently, tissue fragmentation has only been approved by the us fda for the treatment of liver tumors. it is said that more than 400 patients have been treated with the device in us medical institutions. the first patient in hong kong is expected to be treated this week.

a reporter from the first financial daily found out from public information that the histotripsy device is a technology developed by the university of michigan in the united states, which provides a non-invasive alternative to surgery, chemotherapy and radiotherapy for cancer.

last november, the u.s. food and drug administration (fda) approved the use of ultrasound to break up tumors (a technique called tissue fragmentation) for human liver treatment.

the histotripsy device is made by a company called histosonics, which was founded in 2009 by engineers and doctors from the university of michigan.

according to the official website of the university of michigan, since 2021, a human trial underway at the university of michigan rogel cancer center and other centers has treated patients with primary and metastatic liver tumors using tissue fragmentation, demonstrating that the technology can meet the main effectiveness and safety goals of the test.

“tissue fragmentation is an exciting new technology that, although in the early stages of clinical application, may offer a noninvasive treatment option for patients with liver cancer,” said mishal mendiratta-lala, professor of radiology at michigan medicine and principal investigator of the u-m trial. “the hope is that it could be combined with systemic therapies to produce a synergistic therapeutic effect.”

tissue fragmentation works by using directed ultrasound to form microbubbles within the tumor. the forces generated by the formation and collapse of these bubbles cause the tumor to rupture, killing tumor cells and leaving fragments to be cleared by the immune system.

"for patients, this means that the treatment is not as harsh on the body as radiation or chemotherapy, there are fewer concerns about drug compatibility, recovery time is much shorter than surgery, and treatment discomfort is less," the university of michigan said.

in addition, the tissue fragmentation system has onboard diagnostic ultrasound imaging, which can be used to plan and observe treatment in real time, allowing doctors to view the "bubble cloud" and the tissue's response to treatment in real time.

potential for systemic immunotherapy

it is also worth noting that the potential benefits of tissue fragmentation are not limited to tumor destruction. last year, a preclinical study in rodents showed that in the process of clearing tumor cells, the human immune system learned how to recognize cancer cells as a threat. this can allow the body to continue fighting the original tumor and help activate the natural immune response to cancer.

“we hope to harness the immune-stimulating effects of tissue fragmentation and combine it with immunotherapy or drug delivery,” said zhen xu, a professor of biomedical engineering at the university of michigan, inventor of tissue fragmentation and co-founder of histosonics. “this would transform tissue fragmentation from a local therapy to one that can treat tumors throughout the body and ultimately cure them.”

public information shows that top medical institutions including nyu langone medical center, university of chicago medical center, and cleveland clinic have introduced this equipment to treat some liver cancers.

however, some experts told the first financial reporter that the reliability of this therapy still needs further verification, including which type of patients it will have better effects on, and it is difficult to conclude whether it can completely eliminate cancer genes.

the cleveland clinic in the united states began using this ultrasound device to treat liver tumors in april this year. david kwon, director of minimally invasive liver surgery at the cleveland clinic digestive disease institute, performed ultrasound fragmentation on a patient with rectal cancer liver metastasis who had undergone surgery in december last year.

"this treatment is non-invasive and the patient recovers quickly after the operation," kwon said. currently, his team has used this ultrasound technology to treat more patients, with an average treatment time of about one hour.

however, he said more research is needed to understand the benefits of tissue fragmentation, including the occurrence and frequency of the "abscopal effect." "i think this non-invasive treatment is complementary to our current liver tumor treatments, including surgery and chemotherapy," kwon said.

the so-called "abscopal effect" refers to a phenomenon observed in cancer patients who receive radiation therapy and ablative treatments. researchers have noticed that in some cases, after radiation therapy, an anti-tumor response can cause untreated tumors to shrink. in some cases, tissue fragmentation may also produce this "abscopal effect."

an authoritative liver cancer expert told the reporter from china business news: "the shattered cancer cell tissue may produce antigens and induce immune responses. however, these immune responses may be somewhat random, depending on the immunogenicity, and the released antigens happen to be related to tumor necrosis."

wechat editor| su xiao