Could focused ultrasound be used to open the blood brain barrier for more effective chemotherapy penetration in patients with high grade glioma? In this single arm, phase 1/2 trial, 34 patients with high grade glioma who were receiving adjuvant temozolomide after maximal resection and chemoradiation underwent microbubble enhanced focused ultrasound targeting the tumor at the beginning of each cycle of chemotherapy. When intravenous microbubbles pass through low intensity focused ultrasound near the tumor, they expand and contract, which stresses endothelial cells and temporarily opens the blood brain barrier. MB-FUS caused mild grade 1-2 toxicity, but overall was tolerated well. Preliminary efficacy was demonstrated by showing new contrast enhancement after each MB-FUS, which was seen in all patients. Furthermore, MB-FUS allowed for plasma cell-free DNA analysis that mirrored patient outcomes. | Woodworth, Lancet Oncol 2025
