An Investigation on Systemic Effects Induced by Magnetic Resonance-Guided Focused Ultrasound Surgery Directed to Bone Metastases

Bone is a frequent metastatic site, and painful bone metastasis is an important issue in cancer management. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a novel hyperthermia technology which guides high intensity ultrasonic energy to ablate bone metastatic lesions and surrounding periosteal nerve endings. The result is rapid and efficient pain relief. We installed and commissioned this system since 2014 and more than 100 cases have been treated. While MRgFUS relieves pain from bone metastasis, local control is also observed. It remains unknown whether such local treatment might accompany systemic effects that may lead to further disease control. In this proposal, we want to test the hypothesis that treating bone metastasis with MRgFUS induces systemic effects relevant to cancer control. We will prospectively recruit 30 patients with bone metastasis that is clinically indicated to receive MRgFUS. Peripheral blood samples will be taken before and a week after the treatment. The samples will be used to analyze treatment-induced changes in immune cytokines, circulating tumor cells, as well as T-cell repertoire diversity. Information derived from biomarker analyses will be correlated to local control and progression-free duration. The results are expected to provide clinical evidence to test if MRgFUS may induce systemic effects that may potentially synergies with cancer immunotherapy for better cancer control.