Ultrasound is a use you may not have thought of: to open the blood-brain barrier and send in anti-cancer drugs

For brain cancer and other cancers of brain metastasis, new therapies may soon be available

The disappearance of brain cancer

Three years ago, Rick, 62, was diagnosed with glioblastoma

Rick underwent surgery, and doctors removed a huge advanced tumor

He then enrolled in a clinical trial at the University of Maryland Medical Center to test a new treatment: to break through the blood-brain barrier and facilitate the entry of chemotherapy drugs into brain lesions

The treatment was effective

Not only Rick, but most of the 14 brain cancer patients who participated in the clinical trial three years ago are still alive

What exactly is this new type of treatment? Let's start with the

Blood-brain barrier

Why is brain metastasis from brain cancer or other cancers more difficult to treat and cause headaches? One of the reasons for this is the presence of
a blood-brain barrier.

The blood-brain barrier is a "firewall" of blood vessels and brain cells that acts as a safety barrier for the brain, helping to protect the brain and regulate the entry and exit of substances, for example, to prevent toxins and pathogens from entering our brains
.

The blood-brain barrier can also block fat from entering brain function, which is why the brain cannot directly use fat for energy, but is highly dependent on glucose or ketone bodies produced after fat metabolism to provide energy
.

Schematic diagram
of the blood-brain barrier.

Source: healthjade.
net/

While protecting the brain, the blood-brain barrier also limits the delivery of drugs to the brain to treat cancer
.

Therefore, for brain cancer, we can not use conventional chemotherapy, and the treatment is severely limited
.

Is there any way to temporarily open the blood-brain barrier and send chemotherapy drugs? One way to do this is ultrasound
.

Ultrasound opens the blood-brain barrier

The full name of the technique that temporarily opens the blood-brain barrier is called magnetic resonance-guided focused ultrasound
.

First, tiny bubbles filled with inert gas are injected into the patient's bloodstream, and then, guided by MRI, ultrasound is used to target a precise area within the tumor, such as an area that may be prone to recurrence after surgery
.

Tiny bubbles will oscillate within the ultrasound field, causing the walls of cerebral blood vessels to temporarily open
.

This opening is not permanent and lasts about four to six hours
.

Within this time window, chemotherapy drugs such as temozolomide can reach the brain cancer foci more smoothly and kill tumor cells
.

For Rick, every month during the treatment period, he would come to the medical center to "open" the blood-brain barrier once and send chemotherapy drugs
.

Fluid biopsy of brain cancer

The temporary opening of the blood-brain barrier is bidirectional, and in addition to facilitating the entry of therapeutic drugs into the brain, DNA fragments and other metabolites of brain tumor cells can also enter the circulatory system, allowing us to evaluate the response of tumor cells to chemoradiation or other treatments through blood genetic testing (liquid biopsy
).

Promising focused ultrasound

Mr.
MRI-guided focused ultrasound is not only used in cancer treatment, but has also been studied
in the treatment of neurological diseases such as Parkinson's disease.

Whether it's cancer or Parkinson's disease, the application of focused ultrasound looks promising and attracts a lot of attention, with more than a dozen companies investing nearly $400 million in this space last year alone to develop treatments for focused ultrasound in a variety of cancers
.

The incidence of insidious glioblastoma is not very high, but other cancers such as lung cancer often develop brain metastases, and these patients are in urgent need of better and more effective treatment
.

Mr.
MRI-guided focused ultrasound may provide safer and more effective treatment for patients with brain metastases
.

At present, the therapy is still in clinical trials, and the cancer degree will continue to be concerned by everyone, so let's wait and see!

Every day that cancer is not conquered, the cancer degree has been "degreed" with thousands of similar patients!

Resources

Cohn, M.
Maryland man with fatal brain cancer lives, sparking hope for an experimental treatment to better guide chemo to tumors.
https://medicalxpress.
com/news/2022-09-maryland-fatal-brain-cancer-experimental.
html.

Click below to learn more about clinical trials