There are several types of ablative therapies that can be used for prostate cancer focal ablation. These include heat modalities:
- High intensity focused ultrasound (HIFU)
- Laser interstitial thermal therapy
- High-pressure steam
- Gold nanoparticle directed therapy
- Microwave ablation
And additional modalities:
- Irreversible electroporation
- Vascular targeted phototherapy
Figure 1 demonstrates the pre-and post-treatment MRIs of lesions treated with the gold nanoshell modality.
Figure 1 – Pre- and post MRI images of prostate tumors treated with gold nanoshell modalities:1
The three-month biopsy following treatment showed 74% (12/16) clinical success with a median prostate-specific antigen (PSA) reduction of 42%. The 12-month biopsy following treatment showed clinical success in 87.5% (14/16) of targeted biopsies. There were no major side effects or complications.
Another multicenter trial involving 44 men with a total of 45 lesions treated with the gold nanoshell modality was recently presented in the “FOCAL2020” meeting. PSA decreased at 12 months was shown in 48% of cases, and 32 lesions (71.1%) were biopsy negative following treatment.
Another emerging modality is MAGFORCE, which is a nanoparticle covered in iron oxide injected into the tumor. It is later exposed to an alternating magnetic field (100 kHz), generating field strength between 4 and 15 kA/m. The magnetic fluid, NanoTherm®, vibrates to therapeutic treatment temperatures in the tumor.
Concluding his talk, Dr. Rastinehad stated that he believes that focal therapy is a growing modality, and in the future, its role might be incorporated to treat more aggressive disease.
Presented by: Ardeshir R. Rastinehad, DO, Mount Sinai Urology, New-York, NY
Written by: Hanan Goldberg, MD, MSc, Assistant Professor, Urology Department, SUNY Upstate Medical University, Syracuse, NY, USA @GoldbergHanan at the 2020 Society of Urologic Oncology Annual Meeting – December 2-5, 2020 – Washington, DC