Dr. Zhen Xu gives a status update on histotripsy's rollout: about 5,000 patients have been treated across roughly 200 clinical sites since FDA approval for liver tumors, with cases also done in Hong Kong, Taiwan, and under Europe's CE mark. A kidney tumor trial has been completed and submitted to the FDA, a pancreas trial is ongoing, and researchers are exploring breast, prostate, thyroid, sarcoma, and skin cancers. She also describes a bigger push into the brain, using histotripsy for tumors, stroke, and epilepsy while sparing neurons that cannot regenerate, and combining it with targeted drug delivery and neuromodulation in a single system.
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Xu notes some clinicians are already using histotripsy off-label on other abdominal organs beyond the approved liver indication.
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She describes an 'all in one' system that can treat through the skull for non-invasive brain surgery while also doing neural modulation and opening the blood-brain barrier for drug delivery.
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Xu frames the brain as a priority because damaging even a few functional neurons during conventional surgery can cause paralysis, unlike tissue in other organs.
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She mentions founding a histotripsy center aimed at mobilizing scientists and funding to accelerate this multi-organ, multimodal expansion.
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56:24All right. Thank you. Yeah. Um, that's, that's a great compliment. Um, I wanted to ask you about the future. So, I mean, as you said, this is like happening now, right? Um, how do we expedite this thing? Cause this needs to like be in every hospital if this is like how great it is. So, so give you a status of a current field is, uh, so far, uh, five thousand patients have been treated, even though it's only like five, uh, three years after AB approval. So it's pretty fast. Okay. So yeah, that's great. And it's all liver? So, uh, uh, so it's proof of liver tumor, but we have seen, uh, some clinicians
57:07doing off-label treatment to think other organs within abdominal region, but primary is liver. And that, uh, it come from 200 sites, clinical sites, uh, mostly within United States, but they are, uh, patients also treated in Hong Kong, Taiwan. Uh, there are also clinical trial, or we also have the CE mark, uh, which is, uh, equivalent of AB approval in Europe. Oh, okay. So that also proved, and also they're
57:51and yeah, so this is kind of, you know, pretty brutal thing. Uh, and, um, there are clinical trials, uh, uh, for tumors in the kidney. Uh, and actually that trial have already been completed and submitted to FDA and there's an ongoing trial for tumor in the pancreas. Oh, so, so that's kind of current status already pretty, pretty big. Uh, and, um, but it is a platform technology that can be used for many, many things. Anything you can think of that a non-invasive removal of tissue can be beneficial for the patients, uh, that it can be potentially useful.
58:33And we are currently looking at different type of cancer, such as, you know, beyond liver kidney pancreas also breast prostate uh thyroid uh, and, you know, like, uh, sarcoma, which is tumor come, coming from muscle and, uh, uh, fat, uh, even skin, just, you know, different type of cancer. Uh, also again, um, brain, I think is something I really want to push for because our neurons cannot be regenerated, right? You, when you do surgery in the brain and a neuron, even, you know, only a few, if you damage and if they are functional neurons can, you know, cause a patient to even
59:16paralyzed, right? So I think, Oh, and like, and like to get to the spot, you have to, you have to kill all the neurons, like on the way down. Right. Right. Okay. Yeah. So, so now in these, uh, so like a brain surgery, uh, you know, you shouldn't treat it, uh, really, uh, lightly because neurosurgeons are fully aware that it, you know, they can basically damage functions. Right. And so, um, so I think this is where his urgency can also be super high impactful because we can treat a target tissue without damaging those neurons in a way. Uh, and we're not looking at just cancer. We're looking at stroke. We're looking at a certain brain tumor, but we're looking
1:00:00at like functional disease, such as epilepsy, right? Things that you can possibly, uh, you know, but beyond that, we are also combining his urgency with drug delivery and, and we have ultrasound ways that can intrude the drug delivery that we can incorporate into the same system. There's also, we are, uh, now we have an all in one system where I can use the same system to treat through the skull to do non-invasive brain surgery, but also doing neural modulation, modulating the neurons, doing, uh, drug delivery through the blob ring barriers, all those combined together.
1:00:42So I think in the future, by doing a multimodal thing combined for the enhanced treatment therapy, uh, is a way to go to really bring a maximum benefits to the patients. And I actually don't think this is a science fiction. It's actually can happen in the near future. Uh, and that's why I'm really, again, doing this histotripsy center to mobilize as many scientists as I can possibly push to, to fund this together. So I think the, uh, future is, and I making announcement here
1:01:24that we are entering a new era of non-invasive surgery and it's already starting.