With a new focused ultrasound clinical trial underway, Fred Wu hopes to play his part in revolutionizing the way we treat pediatric brain cancer.
To solve some of the trickiest, most deadly brain cancers in the world, Cheng-Chia “Fred” Wu is combining technology and medicine in an unconventional way: he’s giving them dance lessons.
Before explaining exactly what that means, it’s important to understand why Wu chose to come to Virginia Tech in the first place. After studying and working at Columbia University, Wu brought his expertise in using focused ultrasound to treat pediatric cancer to the Fralin Biomedical Research Institute at VTC. He now runs two labs, at the Fralin Biomedical Research Institute in Roanoke — where he’s an assistant professor — and as a collaborator at the Children’s National Brain Tumor Institute at its Research & Innovation Campus in Washington, D.C.
Wu is hoping to leverage Virginia Tech’s resources and cross-disciplinary progress to use focused ultrasound — or targeted, low intensity soundwaves — to treat some of the most ruthless cancers, like diffuse midline glioma (DMG). Unlike other cancers, DMG doesn’t form easily identifiable masses that a doctor can remove. “They spread out as individual cancer cells in a diffuse manner,” said Wu. “And they stay behind this barrier.”
That barrier is the blood-brain barrier, the body’s natural defense perimeter to keep the brain safe from pathogens that enter the bloodstream. It routinely saves us from infections reaching the brain. But its filter has also made delivering potentially life-saving medication an impossibility, at least until recently. In the last decade or so, doctors have begun to find ways of using focused ultrasound to help deliver microbubbles filled with medication across this barrier to treat disease in the brain.
To do that, they have to make those microbubbles dance. It’s a concept Wu will be explaining in more detail at Tech on Tap at Virginia Tech’s Academic Building One in Alexandria on Oct. 1.
“These microbubbles float through the bloodstream and when they reach the area where the soundwave meets, the sound essentially causes the bubbles to dance to the rhythm of the beat,” said Wu. “The bubbles grow and shrink in a rhythmic fashion, and that rhythmic pumping can create a temporary opening of the blood-brain barrier.”
Not only does this non-invasive procedure allow the drugs to reach their intended target, but it also allows researchers to gather information about the tumor cells through the bloodstream. Wu has found they are able to create something of a homing beacon for the local inflammatory process, potentially allowing them to leverage drug delivery in combination with local inflammation and use that as a positive feeder to make immunotherapies more effective.
Focused ultrasound also allows drugs to reach the brainstem, where these tumors often occur, a particularly sensitive part of our central nervous system that regulates functions like swallowing, heart rate, and breathing.
“As you can imagine, any surgical procedure is very, very difficult, and lots of medicines have failed to improve (outcomes),” said Wu.
But some of those medicines may simply not have been able to reach their target, due to the resilience of the blood-brain barrier. That is why Wu believes that solving the delivery method could have much more widespread applications for treating diseases in the brain.
“The part that excites me is that the opportunities are unlimited. There are so many drugs that have failed at clinical trials that if one drug showed the possibility of opening the blood-brain barrier better, it kind of brings back this revival of opportunities that may have otherwise failed,” he said.
Being at Virginia Tech gives Wu not just the ability to conduct his own research, but also the ability to draw on what’s being done around the university. The K9 clinical trials that John Rossmeisl is conducting at the Virginia-Maryland College of Veterinary Medicine are providing valuable information as Wu enters his own human clinical trials. And in the College of Engineering, researchers are working on hardware designed for this actual purpose that might one day reside in oncology treatment labs everywhere.
“We’re partnering with different levels of mechanical, biomedical, and chemical engineering to see if we can adapt some of these methods and create a novel device from the ground up, leveraging the medical fields and current infrastructure so we can have a device that makes sense,” said Wu.
Wu’s work also connects two institutions recognized by the Focused Ultrasound Foundation as Centers of Excellence: Virginia Tech and Children’s National Hospital, where his research labs are based.
Running two research labs in different states on top of being a practicing physician may seem like a lot of work. And it is — Wu readily admits his life would be much easier not spending the time he does on research. So why do it?
“At some point, you have the whiff test, and you have this belief that we’re so close to making a breakthrough,” he said.
While he’s under no illusion that he’s some kind of singular pioneer in the field of focused ultrasound, he does believe that he might be able to play some small part in making that breakthrough, and he understands what that would mean for the people he welcomes into his office every day.
“As a radiation doctor, I see this technology within the grasp of possibility of really creating change for the patients I treat all the time,” he said. “And I feel that my field of radiation oncology is the natural form of medicine that can adopt it.”
Source: VirginiaTech