The literature describing the use of low-intensity ultrasound in four major areas of cancer therapy-sonodynamic therapy, ultrasound-mediated chemotherapy, ultrasound-mediated gene delivery and anti-vascular ultrasound therapy-was reviewed. Each technique consistently resulted in the death of cancer cells, and the bio-effects of ultrasound were attributed primarily to thermal actions and inertial cavitation. In each therapeutic modality, theranostic contrast agents composed of microbubbles played a role in both therapy and vascular imaging. The development of these agents is important as it establishes a therapeutic-diagnostic platform that can monitor the success of anti-cancer therapy. Little attention, however, has been given either to the direct assessment of the mechanisms underlying the observed bio-effects or to the viability of these therapies in naturally occurring cancers in larger mammals; if such investigations provided encouraging data, there could be prompt application of a therapy technique in the treatment of cancer patients.

A review of low-intensity ultrasound for cancer therapy.

Sonodynamic therapy is a potential cancer treatment modality that has been gaining support due to its effectiveness in both in vitro and in vivo studies. The therapeutic method combines ultrasonic irradiation with drugs known as sonosensitizers that amplify its ability to inflict preferential damage on malignant cells. This is based on the idea that ultrasonic waves have the ability to exhibit profound physical and chemical changes on cellular structure. The mechanisms by which ultrasound (US) disrupts cellular functioning can be further amplified when sonosensitizers are applied. Combining multiple sonosensitizers with US to create a substantial synergistic effect could be an effective method for destroying tumorigenic growths, while decreasing the likelihood of drug resistance.

The promise of sonodynamic therapy

Limited penetration of chemotherapeutic drugs through the blood brain barrier (BBB), and the increased chemo-resistance of glioma cells due to macroautophagy/autophagy, result in high tumor recurre...

Manipulation of Mitophagy by "All-in-One" nanosensitizer augments sonodynamic glioma therapy.

Anti-metastatic and pro-apoptotic effects elicited by combination photodynamic therapy with sonodynamic therapy on breast cancer both in vitro and in vivo.

Therapeutic ultrasound has been used to thermally ablate solid tumors since the 90s, and a variety of cancers are presently being treated clinically, taking advantage of ultrasound- or MR-imaging guidance and monitoring. However, an ever-increasing body of preclinical literature demonstrates how ultrasound can achieve bioeffects beyond thermal ablation, including non-invasive drug delivery to target cancer cells. In this review, we will provide a summary of in vivo ultrasound-based strategies shown to deliver drug payloads to tumor environments, to enhance permeability of vessel walls and cell membranes, and to activate drugs and genes in situ .

/pdf/review-of-ultrasound-mediated-drug-delivery-for-cancer-1fajvb2e3p.pdf

Review of ultrasound mediated drug delivery for cancer treatment: updates from pre-clinical studies

Initiation of autophagy and apoptosis by sonodynamic therapy in murine leukemia L1210 cells.

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Initiation of autophagy and apoptosis by sonodynamic therapy in murine leukemia L1210 cells.