Although still a busy consultant in the field, Lawrence A. Crum, PhD, recently retired as a Research Professor of Bioengineering and Electrical Engineering at the University of Washington (UW). He has also retired from his posts as Principal Physicist in UW's Applied Physics Laboratory and as Founder/Past Director of the Center for Industrial and Medical Ultrasound, a translational research enterprise that builds collaboration between industry, research, and academia for the development of technology.
To capture the history and work of this focused ultrasound visionary, the Foundation's Chief Scientific Officer, Jessica Foley, PhD, interviewed Dr. Crum. She first met him almost 20 years ago, when she arrived at the University of Washington to begin her PhD work. Although Shahram Vaezy, PhD, was her direct advisor, Dr. Crum encouraged her to pursue focused ultrasound research, served on her dissertation committee, and supported her work then – and throughout her career.
The traditional path to bring new medical therapies from the laboratory bench to the patients' bedside is relatively straight: Test first in cell culture, then in small laboratory animals, next in larger laboratory animals, and finally in humans. However, this process has resulted in a spectacularly high failure rate. Recent studies indicate that less that 10 percent of drugs entering clinical trials receive FDA approval – and that success rate is even lower for chemotherapeutics. Why do so many drugs, particularly chemotherapies, fail in clinical trials?
One significant weakness in the development pipeline is the preclinical data used to determine whether a specific drug warrants a clinical trial. This crucial evidence usually comes from small animal studies – in other words, the mouse. Laboratory mice live extremely well-controlled lives: Their diets and environments are sterilized and standardized. Their light exposure and temperature are carefully regulated. Mice in a study are the same age and are virtually indistinguishable genetically. All of this is intentional – it reduces the number of variables and confounding factors, simplifying data analysis. But does this decades-old system do more harm than good?
[This blog was adapted from a presentation made by Morry Blumenfeld on June 14, 2019, at the joint meeting of the International Society for Therapeutic Ultrasound (ISTU) and the European Focused Ultrasound Charitable Society (EUFUS) in Barcelona, Spain.]
In June, I was honored to have been invited by EUFUS to present a tribute to my close friend, Professor Ferenc A. Jolesz, who was instrumental in all the subjects that were considered during the recent ISTU/EUFUS meeting in Barcelona. I am privileged to have taken part in the journey that Ferenc and I experienced together in the development of image-guided therapy and focused ultrasound.
In the foreseeable future, our shared vision is that the lives of millions of people around the world will be improved, and the cost of their care will be reduced, as a result of a revolution in therapy created by focused ultrasound – a noninvasive, game-changing, highly disruptive technology that is an alternative or supplement to traditional surgery, radiation, drug therapy, and immunotherapy.
Scale of Focused Ultrasound Technology
The revolution in therapy created by focused ultrasound will be of the same magnitude as the revolution in diagnosis created by magnetic resonance (MR) imaging, in terms of impact on health and wellness. And, like MR scanning, it will result in a multibillion-dollar industry.
As the chief medical officer of the Foundation, I am occasionally asked what I would do to manage prostate cancer if I were ever diagnosed with it. There are many factors to consider, including:
Consider this hypothetical example: if I were diagnosed with low-risk prostate cancer (Gleason 3 + 3), I would be eligible to receive focal treatment – as opposed to hemi-ablation or whole-gland ablation. However, my physician would be unlikely to recommend any treatment, invasive or otherwise.