Research progress on the antitumor immune regulation mechanisms and combined treatment strategies of histotripsy: A review

Histotripsy is a noninvasive, nonionizing, nonthermal ablation technology approved by the US FDA for liver cancer treatment in 2023. It exerts antitumor effects via focused ultrasound cavitation, with unique immunomodulatory advantages. Core mechanisms include inducing immunogenic cell death to form an “in situ vaccine,” reshaping tumor microenvironment immune cell infiltration, regulating cytokine networks, and triggering a CD8 + T cell-mediated ferroptosis-related “abscopal effect.” Combined with immune checkpoint inhibitors, antiangiogenic drugs, or chemotherapy, it shows significant synergistic efficacy. Clinical trials such as #HOPE4LIVER confirm its 95% technical success rate in hepatocellular carcinoma. With further optimization, Histotripsy is expected to benefit more solid tumor patients.