# Harnessing the therapeutic potential of histotripsy focused ultrasound-induced immunogenic cancer cell death

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2024 · $78,847

## Abstract

PROJECT SUMMARY/ABSTRACT
 Immunotherapy can be highly effective against cancers that elicit some recognition from the immune
system (e.g., melanoma), but it remains ineffectual against cancers that are largely invisible to immune detection
(e.g., pancreatic cancer). Advances in cancer immunotherapy will require interventions that can make cancers
more apparent to the immune system. A growing body of evidence suggests that focused ultrasound (FUS)
tumor ablation could be that intervention. By non-invasively disrupting cancer cells, thermal and mechanical
modes of FUS have been shown to trigger surprisingly potent immune responses against tumors. We have
found that histotripsy, a non-thermal mode of mechanical FUS, stimulates a powerful and systemic anti-tumor
immune response strong enough to cause abscopal regression of distant, non-ablated tumor sites – effects not
generally seen with traditional therapies like radiation or thermal ablation. Histotripsy is a technology that is
presently being introduced into clinical use; therefore, it will be imperative to understand the mechanistic
underpinnings of histotripsy immunostimulation. Our preliminary studies point to a stepwise series of events that
may explain this phenomenon. First, histotripsy causes the release of subcellular cancer cell antigens in a
manner that preserves their immunogenic integrity. Second, histotripsy induces cancer cells to undergo a
specific pathway of cellular suicide called necroptosis – a death pathway that attracts inflammation and immune
attention, effectively priming the immune system to recognize cancer antigens. What follows is a progressive
infiltration of CD8+ T cells into distant tumors that is accompanied by another pathway of cancer cell death called
ferroptosis – a death pathway recently discovered to be the critical mechanism by which immunotherapy-primed
CD8+ T cells kill cancer cells.
 In this proposal, we will retrace these steps to understand how histotripsy exerts its unusually potent
immune effects. First, we will quantitatively fine-tune the parameters of histotripsy tissue cavitation that cause
maximally immunogenic tumor antigen release. Next, we will focus on the early induction of necroptosis to
determine if this is a necessary local precursor event on which later manifestations of histotripsy
immunostimulation depend. Then, we will examine the later process of CD8+ T cell-driven ferroptosis to
determine if this is the mechanism by which the distant, abscopal effects of histotripsy are mediated. Finally, we
will leverage mechanistic insights gained from these investigations to develop and test potential preclinical
strategies with which the effects of histotripsy on tumor antigen release, necroptosis, and ferroptosis could be
maximized for cancer immunotherapy. We have assembled a multidisciplinary team with expertise in FUS,
immunology and cancer immunotherapy to pursue this work, which promises to reveal insights and strategies to
bring the impact...

## Key facts

- **NIH application ID:** 10853130
- **Project number:** 5R01CA269394-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Clifford Cho
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $78,847
- **Award type:** 5
- **Project period:** 2023-06-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10853130

## Citation

> US National Institutes of Health, RePORTER application 10853130, Harnessing the therapeutic potential of histotripsy focused ultrasound-induced immunogenic cancer cell death (5R01CA269394-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10853130. Licensed CC0.

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