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Sound Blade Closes $23.8-million Series A For Ultrasound Tech Targeting Liver Tumours

Halifax-based medtech startup Sound Blade has secured $16.5 million USD ($23.8 million CAD) in Series A funding to develop its handheld device for eliminating liver tumours non-invasively.

Montréal-based Lumira Ventures and New York, NY-based Amzak Health led the round, with additional backing from Invest Nova Scotia.

Sound Blade said it would use the funding to expand its team and accelerate the development of its technology for eventual use in the clinic.

Sound Blade has developed a handheld ultrasound device it says can target and destroy cancerous and benign liver tumours. The non-invasive technique, called histotripsy, uses ultrasound waves to precisely eliminate tumours and leave the surrounding tissue intact. Ultrasound waves permeate the skin and create bubbles in the tumour, which collapse so quickly that they liquefy the tissue.

The Canadian Cancer Society estimated that in 2024, 4,700 Canadians would be diagnosed with liver cancer and 3,700 would succumb to the disease. Compared to surgery or radiation, Histotripsy leads to "less blood loss, fewer complications, reduced recovery time, and decreased chance of infection," according to Sound Blade.

RELATED: Doctor-led Oxford Cancer Analytics closes $16-million CAD Series A to improve early lung cancer detection

Dr. Tony Natale, partner at Amzak Health, said Sound Blade's handheld device has "truly disruptive potential." 

The company said it would use the funding to expand its team and accelerate the development of its technology for eventual use in the clinic. BetaKit has reached out to Sound Blade for clarity on what stage the company is at in the regulatory process. 

Sound Blade's funding round comes after another challenging year for healthtech funding in Canada, according to a recent report by Vancouver-based Pender Ventures. Venture backing in the sector hit $700 million CAD, an 18-percent drop from the year before. 

This also marks Lumira Ventures' second investment into histotripsy, following its investment into Michigan-based HistoSonic, whose device has received approval for "de novo" classification from the U.S. Food and Drug Administration. 

Feature image courtesy Unsplash.

Ultrasound And Nanobots — A Deadly Duo Against Cancer

A researcher sees a patient's most painful and intimate moments when developing new treatments for cancer. Working assiduously to improve those treatments, some progress is made. Occasionally, there are miracles.

That's what happened at Tokyo Women's Medical University in 2015. While conducting safety trials of experimental ultrasound therapy on a 12-year-old dog with a terminal-stage chondrosarcoma — its weakened pelvic bone so swollen the animal couldn't stand — they were amazed to see the dog walking again shortly after a single treatment.

A high-intensity focused ultrasound system, sponsored by Japan Science and Technology Agency; [Inset] a vial of nanocarriers

"It was a completely unexpected result — we were just testing for safety," says Professor Yoshihiro Muragaki of the university's Faculty of Advanced Techno-Surgery. "The improvement was very dramatic. The dog couldn't walk when he arrived. But after a week, he was walking again and could even run steadily on all four legs. CT scans showed the tumour had been reduced by 15%."

With the animal stable two months after treatment, a second round of sonodynamic therapy was performed, resulting in even more improvement: the dog could excrete again naturally. Follow-up scans four months later showed only a minimal increase in tumour volume.

"This dog survived for more than two years after two treatments," adds Muragaki. "In human terms, that's an extra 10 years of survival from terminal bone cancer."

Another three dogs with inoperable tumours underwent sonodynamic therapy; one had bone cancer, one liver cancer and one prostate cancer and a metastatic lung tumour. All improved after treatment, and in the last dog, the calcified mass inside the prostate tumour disappeared within 49 days and no lung tumour could be detected with radiographic imaging. None of the animals suffered adverse effects during irradiation and no abnormalities were detected in haematological or biochemical tests.

The canine trials were exciting because cancers in dogs are very similar to human cancers — at times, functionally identical. And sonodynamic therapy had already succeeded in in vivo trials on mouse models of colon and pancreatic cancer.

The first in-human trial of sonodynamic therapy for unresectable pancreatic cancer at Tokyo Medical University

Muragaki began exploring high-intensity focused ultrasound (HIFU), along with drugs that help destroy solid tumours, in 2007. His team developed a system consisting of a diagnostic ultrasound probe tailored to locate and tag tumours, coupled with a precision robot HIFU transducer, and specialized software that controls the robot and helps it navigate based on an MRI map of the tumour and live data from the ultrasound probe.

The HIFU transducer itself is novel: a flexible robot arm with six axes of movement, developed by Tohoku University, which fires beams in a specialized pattern called trigger pulses. The pulses activate polymer nanocarriers, or micelles, injected intravenously the day before, which then disgorge their embedded anti-cancer agents, epirubicin or doxorubicin.

"We don't know the exact mechanism that leads to this dramatic effectiveness," says Muragaki. "It may be that the focused ultrasound helped the drug work better by destroying the tumour. Or active oxygen was generated by sonodynamic therapy. Or perhaps the ultrasound destroyed the micelle capsule and boosted delivery of the anti-cancer agent in the cancer cell. Or it could be all three."

Human trials are underway, and early results are encouraging. Researchers believe the potential for sonodynamic therapy, especially in late-stage pancreatic cancer, is extremely attractive: it's minimally invasive, has few side effects, and requires just half to one-sixth the dose of drug-laden micelles used in chemotherapy, says Muragaki: "There's no anaesthesia, the patient lays down on a bed, and it takes around 20 or 30 minutes."

If successful, Muragaki is keen to deploy the treatment in the faculty's premier project: the Smart Cyber Operating Theater (or SCOT®), which he also leads. Established in 2000 as the Intelligent Operating Theater — an initiative to boost interoperability between the multitude of stand-alone medical devices in modern surgery — it has since spawned into a fully networked, robot-assisted surgical theatre with real-time monitoring and display of a patient's condition during surgery.

The TWMU team in the Hyper Smart Cyber Operating Theater ® sponsored by Japan Agency for Medical Research and Development

Its latest incarnation, HyperSCOT®, looks like a scene from Star Trek: a room filled with networked equipment spiralling toward a central operating table, encircled by large high-resolution screens. A video feed of the operation is surrounded by live data from various instruments on a single screen, and the physician occupies a 'surgeon's cockpit' — a robot that supports their arms and wrists, making hands steadier and arms tire less easily.

Surgeries continued even as the SCOT® concept evolved: some 1,900 operations were completed (mostly on brain tumours in the precursor theatre to SCOT®), and the results were better than those from conventional theatres. In a study of 525 glioma operations in the theatre, the 5-year survival rate for grade II tumours was 93%, compared to an average of 75% in Japan. In fact, progression-free survival time for grade-II gliomas treated in the precursor theatre was 7.5 years, unmatched by any other hospital.

The surgery department of Tokyo Women's Medical University Hospital has 296 types of medical devices. The goal is to network all of them into the HyperSCOT®, says Muragaki: "We want to turn the operating theatre into a single medical device."

Manchester Researchers Awarded £1 Million To Test Potential Life-saving Technology For Early Detection Of Liver Cancer

Manchester researchers have been awarded over £1 million by NHS England to explore the use of an innovative test for liver cancer, which will help patients access earlier care and potentially save lives.

The team at Manchester University NHS Foundation Trust (MFT) and The University of Manchester (UoM) will implement the new technology across MFT hospitals. The test aims to improve early detection of hepatocellular carcinoma (HCC) – the most common cancer affecting the liver and the third most common cause of cancer death.

One of the risks for developing HCC is a pre-existing liver disease and scarring of the liver, known as cirrhosis. Around two in 100 patients with cirrhosis will develop HCC every year.

In early, curable stages, HCC can have no symptoms and so it is recommended that everyone with known cirrhosis is tested twice a year. Unfortunately, even with current recommended surveillance, more than half of these patients are diagnosed with HCC at a stage where it cannot be cured.

The project is supported by Roche Diagnostics who developed the test, called Elecsys®GAAD alongside researchers at MFT, UoM and not-for-profit organisation, Vocal who provided valuable input from people affected by liver cancer.

Elecsys®GAAD is being fast-tracked into the NHS at MFT, which provides specialist liver care to the Greater Manchester region. It will be used alongside routine surveillance tests to see how it can benefit patients, so they have the best chance of surviving this type of cancer.

The technology is a fully regulated, accurate test that combines blood tests with gender and age, which indicates the presence of HCC.

Project lead Dr Varinder Athwal, Consultant Hepatologist at MFT and Honorary Senior Lecturer at the University of Manchester, said: "Manchester has some of the highest rates of liver disease and liver cancer in the UK and far too many people are diagnosed when curative treatment is not possible. We need better tools to identify liver cancer earlier, when it can be cured. This innovation is a non-invasive test that easily fits into our current pathway, and we hope that it will enable us to diagnose more people at early, curable stages of primary liver cancer. As one of the largest trusts in the country, MFT is uniquely placed to test the innovation."

Professor Rick Body, Group Director of Research and Innovation at MFT, said: "We are delighted to receive this funding and very proud to deliver this important research at MFT. Early diagnosis of cancer provides the best chance for successful treatment, which is why implementing this innovative test is so important. We are hopeful that this research will have a huge impact on the future of diagnosis for HCC and will ultimately save lives."

Professor Neil Hanley, Vice-Dean for Research and Innovation at UoM said: "This new innovative test is a really exciting development and further compelling evidence that if we pull on our strength working across university, NHS and commercial boundaries we will translate research into innovations that make a real difference to people's lives."

Dr Annie Keane, Deputy Director of Vocal, hosted by MFT and UoM, said: "We're delighted to support this vital project to bring about better outcomes for people with liver cancer. We've worked with the public to develop the funding bid from an early stage. We'll continue to work in partnership with patients and the public to ensure they are meaningfully involved throughout, including the implementation of the test, as members of the core project team."

Chris Hudson, Director of Access and Innovation at Roche Diagnostics UK and Ireland said: "We are thrilled this funding award from NHS England gives us the opportunity to build on the trusted partnership we already have with colleagues in Manchester and the important work we are doing together to identify liver disease more accurately and sooner. By bringing together the collective knowledge and expertise of academic, medical and industry partners, this new project has the potential to streamline the diagnosis and treatment pathway for patients with liver cancer across the UK, to improve their experience and outcomes, and help alleviate pressure on the NHS."

Work to rollout Elecsys®GAAD will be supported by Health Innovation Manchester, in partnership with the Greater Manchester Cancer Alliance, The Christie NHS Foundation Trust and Macmillan Cancer Support.

Findings from the implementation of the test at MFT will be used to co-develop a plan for the national roll out of the technology. This is supported by National Institute for Health and Care Research London MedTech In Vitro Diagnostics Co-operative, Imperial College London - who are observing the impact of the new technology on the NHS and Unity Insights who are carrying out an independent evaluation of the findings across the project. 

This work was commissioned and funded by the NHS Cancer Programme, with the support of SBRI Healthcare and the NHS Accelerated Access Collaborative (Project Reference Number NCPC02013). The views expressed in the publication are those of the author and not necessarily those of the NHS Cancer Programme or its stakeholders. 

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