Examining LIFU-Aided Liquid Biopsy in Glioblastoma: Deriving Benefit From the Technology

In this second episode of OncChats: Examining LIFU–Aided Liquid Biopsy in Glioblastoma, Manmeet Singh Ahluwalia, MD, MBA, FASCO, and Michael W. McDermott, MD, both of Baptist Health South Florida, discuss the success observed with low-intensity focused ultrasound (LIFU) in essential tremors and the hope for this approach in brain cancer.

Ahluwalia: Great, congratulations on some groundbreaking work. I know we’ve seen numerous patients with essential tremors really getting instantaneous benefit from high-intensity focused ultrasound. Could you talk to us a little bit about how you’ve seen patients derive benefit from this technology?

McDermott: My colleague, Justin Sporrer, MD, of Baptist Health South Florida, has treated over 100 patients with essential tremor since September 2021, when it was FDA approved and approved by Medicare. The benefit of this approach has been very dramatic, and as you said, it’s instantaneous.

We are using LIFU for targeting newly diagnosed or recurrent malignant gliomas 24 hours before surgery, collecting blood samples at 1, 2, and 3 hours after sonication, and then tissue biopsies at surgery. We’ve treated three patients on a clinical protocol for the liquid biopsy, as it’s called, using the low-intensity transducer to disrupt the blood–brain barrier in the hopes that we may be able to find small circulating tumor DNA [ctDNA] molecules in the patient’s circulation after the blood–brain barrier disruption. We’re correlating that with histochemical features that we derived from biopsies of the patient’s brain at the time of surgery. These are patients with newly diagnosed or recurrent gliomas, and they have surgery within 24 hours of LIFU.

Now, we don’t offer any potential therapeutic benefit from the LIFU, but it may help future patients. If we identify these molecules with consistency and sensitivity, those molecules could be used to help with diagnosis and to monitor the effects of treatment. There is a theoretical possibility that release of other protein compounds during the treatment may stimulate the immune system and lead to an indirect immune response to the tumor, which may prolong the time of tumor control.

Check back next Tuesday for the next episode in the series.