Review Traces Histotripsy From Lab to FDA-Approved HCC Therapy

This review describes histotripsy, a noninvasive focused ultrasound technique that ablates liver tumors via acoustic cavitation rather than heat, and traces its development from preclinical studies to FDA approval for liver tumors in October 2023. The review reports that clinical trials THERESA and #HOPE4LIVER demonstrated safety, with #HOPE4LIVER showing approximately 95% technical success and approximately 90% one-year local control, and notes preclinical evidence of immune cell infiltration suggesting possible abscopal effects. The review states current evidence supports optimal outcomes for tumors 3 cm or smaller and highlights potential advantages for perivascular lesions where heat-sink effects limit thermal ablation.

Most relevant for: Patients with hepatocellular carcinoma, particularly those with tumors 3 cm or smaller or perivascular lesions where thermal ablation techniques are limited by heat-sink effects.

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