Focused ultrasound as a therapeutic adjunct in pancreatic cancer: from thermal and mechanical effects to immune modulation
Year: 2026
Type: article
Abstract: Pancreatic cancer remains highly lethal, with only limited improvements achieved with surgery, chemotherapy, radiotherapy, or immunotherapy. Focused ultrasound (FUS) offers complementary, noninvasive therapeutic modalities-including thermal ablation, non-ablative mechanical stimulation, and histotripsy-that can debulk tumors, palliate pain, enhance drug delivery through modulation of the dense stromal environment, and stimulate antitumor immunity. Extracorporeal high-intensity focused ultrasound is clinically feasible, while endoscopic and intraoperative approaches aim to overcome anatomical constraints. Preclinical studies demonstrate cavitation-mediated increases in tissue permeability and immune activation, and early clinical trials combining FUS with chemotherapy have reported encouraging signals in response rates and survival outcomes. Ongoing investigations are evaluating synergistic effects with immunotherapies and targeted drug delivery strategies. Key challenges-including the deep anatomical location of the pancreas, its fibrotic microenvironment, and the low immunogenicity of pancreatic tumors-necessitate the standardization of treatment parameters and improvements in image guidance. Overall, FUS represents a promising adjunct within multidisciplinary pancreatic cancer care.
Source: ULTRASONOGRAPHY
DOI: 10.14366/usg.25199
Institutions: Seoul National University, Seoul National University Hospital, Lyon 1 Université, Inserm, Centre Léon Bérard, Laboratoire des applications Thérapeutiques des Ultrasons, Institute of Cancer Research, University of Virginia, Virginia Tech, University Hospital Cologne, Focused Ultrasound Foundation
Language: English
Subfield: Biomedical Engineering
Field: Engineering
Domain: Physical Sciences
Open Access status: diamond
OpenAlex ID: W7160011469