title: Ultrasound-based combination therapy: potential in urologic cancer.
abstract: Immune-sensitive urologic malignancies include prostate, kidney and bladder cancers. To date, most immunotherapeutic treatments have been applied to advanced metastatic disease. Limited efficacy in this setting is likely due to an excessive disease burden, which overwhelms the capacity of the immune system. Immunotherapy has not been widely utilized in a low-disease-burden state - a setting in which the immune system may be best suited to effectively mount a clinically meaningful response. The emergence of high-intensity focused ultrasound, and more recently, low-intensity focused ultrasound technologies, have demonstrated not only immune-stimulatory effects but also an interesting capacity to alter tissue architecture and cell membrane properties, which may be exploited to increase tumoral uptake of drugs and vaccines. In this article, we review the literature supporting the novel use of ultrasound combination therapy with adjunctive agents in the treatment of urologic malignancy.
authors.affiliation: Institute of Urologic Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. dfinley@mednet.ucla.edu
authors.forename: David S
authors.initials: DS
authors.lastname: Finley
authors.forename: Frederic
authors.initials: F
authors.lastname: Pouliot
authors.forename: Brian
authors.initials: B
authors.lastname: Shuch
authors.forename: Arnold
authors.initials: A
authors.lastname: Chin
authors.forename: Alan
authors.initials: A
authors.lastname: Pantuck
authors.forename: Jean B
authors.initials: JB
authors.lastname: Dekernion
authors.forename: Arie S
authors.initials: AS
authors.lastname: Belldegrun
mesh_terms: D003131:Combined Modality Therapy; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D014464:Ultrasonic Therapy / Q000379:methods; D014463:Ultrasonography; D036761:Ultrasound, High-Intensity Focused, Transrectal / Q000379:methods*; D014571:Urologic Neoplasms / Q000000981:diagnostic imaging* / Q000276:immunology / Q000628:therapy*