# Sonodynamic therapy

Source: https://onco.cc/technologies/sonodynamic-therapy/  
OnCo record `sonodynamic-therapy` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A drug that does nothing until ultrasound hits it, then kills the cells that took it up. Being tested in brain tumours because sound reaches where light cannot.

## Summary

5-ALA accumulates as protoporphyrin IX in glioma cells; focused or diffuse ultrasound then generates reactive oxygen species locally. Alpheus Medical is running a phase 2 in newly diagnosed glioblastoma with adjuvant temozolomide (NCT07225621, recruiting) after a completed phase 1 (NCT05362409); Insightec's ExAblate platform completed a phase 2 (NCT04845919) and investigator studies are recruiting in recurrent glioblastoma (NCT06039709). No randomised survival data exist yet.

## Fields

- Kind: Technology
- Status: phase-2
- Last checked: 2026-09-08
- Tags: frontier; promising
- Principle: A sonosensitiser concentrates in tumour cells; ultrasound induces cavitation and reactive oxygen species that kill sensitised cells while sparing normal brain.
- Strengths: Ultrasound penetrates deep tissue, unlike light; Uses a sensitiser already approved for fluorescence-guided surgery; Non-invasive and repeatable
- Limitations: No phase 3 or survival data; Sensitiser uptake varies across a heterogeneous tumour; Treatment planning and dosimetry are immature

## Sources

- Alpheus phase 2 in GBM (NCT07225621): https://clinicaltrials.gov/study/NCT07225621
- ExAblate SDT phase 2 (NCT04845919): https://clinicaltrials.gov/study/NCT04845919

## Connected records

- roadmaps: [Devices and physical therapies roadmap: heat and light → electric fields and focused sound → drug-releasing implants](https://onco.cc/roadmaps/devices-roadmap/), [Radical oncology: what could change the war by 2035](https://onco.cc/roadmaps/frontier-2035/)
- cancers: [Glioma & glioblastoma](https://onco.cc/cancers/glioblastoma/)
- fronts: [Devices & Physical Therapies](https://onco.cc/fronts/devices/), [Radiation Therapy](https://onco.cc/fronts/radiation/)
- technologies: [Fluorescence-guided surgery](https://onco.cc/technologies/fluorescence-guided-surgery/), [Focused ultrasound & histotripsy](https://onco.cc/technologies/hifu-histotripsy/), [Focused-ultrasound blood-brain barrier opening](https://onco.cc/technologies/bbb-focused-ultrasound/), [Photodynamic therapy lasers and light sources](https://onco.cc/technologies/photodynamic-therapy-lasers/), [Photoimmunotherapy & photodynamic therapy](https://onco.cc/technologies/photoimmunotherapy/), [Transcranial focused ultrasound systems (Exablate Neuro, SonoCloud)](https://onco.cc/technologies/transcranial-focused-ultrasound-systems/)
- companies: [Insightec](https://onco.cc/companies/insightec/)

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