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Independent Singapore

Could tiny bubbles be the future of cancer care? Singapore's new clinical trial says 'yes'

SINGAPORE: In a quiet but potentially trailblazing move, Singapore is slated to introduce medical trials in the second half of 2025 for a novel, nonintrusive treatment that utilises bubbles. However, these are not ordinary bubbles; these are microbubbles designed to destroy liver tumours without taking out a single layer of skin. According to a recent Healthcare Asia article, this next-generation treatment, known as histotripsy, employs intensive ultrasound to generate microscopic bubbles in the liver. These bubbles quickly inflate and collapse, crashing tumours reflexively — not thermally — which could lessen problems and protect adjacent healthy tissues. 'This technique may also enhance other treatment strategies such as immunotherapy,' said Dr. Glenn Bonney, senior consultant at the National University Hospital and National University Cancer Institute, Singapore. A first for Southeast Asia The clinical trial, involving 40 patients at the Singapore General Hospital (SGH) and the National Cancer Centre Singapore (NCCS), specifically targets individuals over the age of 21 with lumps smaller than three centimetres who are not candidates for surgical procedures. The trial will evaluate the tumour's reaction over six months and keep a close eye on possible complications and aftereffects. If the outcomes are encouraging, regulatory endorsement will be pursued, said Dr. Brian Goh, head of hepatopancreatobiliary and transplant surgery at SGH and NCCS. A decade in the making The expertise behind this invention came from the University of Michigan, where a team led by biomedical engineering professor Zhen Xu has spent over a decade finalising the science. 'Histotripsy uses microsecond-length ultrasound pulses at very high pressure,' Xu explained. 'This requires new instrumentation that did not exist commercially.' In contrast to high-intensity focused ultrasound, which scalds tissue employing heat, histotripsy functions more like an infinitesimal jackhammer, mildly disruptive, yet highly targeted. Xu, who co-developed the platform and co-founded the company HistoSonics, said the team had to build their equipment from nothing to bring this idea to life. Backed by big philanthropy Singapore's entry into this turf is boosted by a substantial $12 million contribution from the Li Ka Shing Foundation and Temasek Trust, which financed the city-state's first histotripsy system. This pioneering machine was bestowed upon NCCS and the National University Cancer Institute as part of a larger push to fast-track cancer innovation in the region. Histotripsy's future is not confined to liver tumours. Researchers are exploring the same platform as a possible treatment for haemorrhagic strokes, epilepsy, and even cardiovascular ailments. Scientists are also trying an all-in-one transcranial device that can 'awaken' the brain through the cranium, a sci-fi-sounding application that's getting closer to reality. A hopeful future With national recruitment projected to complete within the year, all eyes are now on the trial outcomes. If the results are satisfactory, Singapore may soon become a regional — or even global — leader in steering this next wave of cancer treatment. As Dr. Goh put it simply: 'If the results are positive, we will apply for the necessary approvals for treatment.' And just like that, the unassuming microbubble may rise as the improbable hero in the fight against one of the most fatal diseases of this era.