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Subject is ≥18 years of age |
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Subject has signed the Ethics Committee (EC) or Institutional Review Board (IRB) approved trial Informed Consent Form (ICF) prior to any trial related tests/procedures and is willing to comply with trial procedures and required follow-up assessments |
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Subject is diagnosed with hepatocellular carcinoma (HCC) or liver metastases (mets) from other primary cancers |
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Subject is able to undergo general anesthesia |
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Subject has a Child-Pugh Score of A or B (up to B8) |
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Subject has an Eastern Cooperative Oncology Group Performance Status (ECOG PS) grade 0-2 at baseline screening |
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Subject meets the following functional criteria, ≤7 days prior to the index-procedure |
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Liver function: Alanine transaminase (ALT) and Aspartate transaminase (AST) <2.5x upper limit of normal (ULN) and bilirubin <2.5x ULN, and |
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Renal function: serum creatinine <2x ULN, and |
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Hematologic function: neutrophil count >1.0 x 10^9/L and platelet >50 x 10^9/L |
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Subject has an International Normalized Ratio (INR) score of <2.0 , ≤7 days prior to |
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the index procedure |
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The tumor(s) selected for histotripsy treatment must be ≤3 cm in longest diameter |
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Subject has not responded to and/or has relapsed and/or is intolerant of other available therapies including locoregional therapies, chemotherapy, immunotherapy and targeted therapies |
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Subject has an adequate acoustic window to visualize targeted tumor(s) using ultrasound imaging |
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Subject has a maximum of three (3) tumors to be treated with histotripsy during the index procedure, regardless of how many tumors the subject has |
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Subject is pregnant or planning to become pregnant or nursing (lactating) during the trial period
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Subject is enrolled in another investigational trial and/or is taking investigational medication or treated with an investigational device ≤30-days prior to index procedure
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In the Investigator's opinion, the subject has co-morbid disease(s) or condition(s) that would cause undue risk and preclude safe use of the HistoSonics System
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Subject has a serum creatinine >2.0 mg/dL or estimated glomerular filtration rate (EGFR) <30, unless on dialysis
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Subject has not recovered to common terminology criteria for adverse events (CTCAE) grade 1 or better from any adverse effects (except alopecia) related to previous anti-cancer therapy
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Subject has major surgical procedure or significant traumatic injury ≤2 weeks prior to the index procedure or not fully recovered from side effects/complications of such procedure or trauma
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Subject has a planned cancer treatment (e.g. resection, chemotherapy, etc.) from the index-procedure date and prior to completion of the 30-day follow-up visit
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Subject has a history of, or suspected to have, bleeding disorders that are uncorrectable
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Subject has a coagulopathy that is uncorrectable
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Subject has previous treatment with bevacizumab that has not been discontinued >40 days prior to the planned index-procedure date
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Subject has planned bevacizumab treatment prior to completion of the 30-day follow-up visit
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Subject has previous treatments with chemotherapy and/or radiotherapy that has not been discontinued ≥2 weeks prior to the planned index-procedure date or has not recovered from related toxicity
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Subject has previous treatment with immunotherapies that has not been discontinued ≥4 weeks prior to the index-procedure or has not recovered from related toxicity
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Subject has a life expectancy less than six (<6) months
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In the opinion of the Investigator, histotripsy is not a treatment option for the subject
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Subject has a concurrent condition that, in the investigator's opinion, could jeopardize the safety of the subject or compliance with the protocol
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Subjects' tumor(s) is not treatable by the System's working ranges (refer to User Manual)
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Subject has a known sensitivity to contrast media and cannot be adequately pre-medicated
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Targeted tumor(s) treatment volume overlaps a non-targeted tumor visible via imaging
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The targeted tumor(s) is not clearly visible with diagnostic ultrasound and computed tomography (CT) or magnetic resonance (MR) imaging
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Subjects' targeted tumor(s) has/have had prior locoregional therapy (e.g. ablation, embolization, radiation)
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Subject is eligible for surgical resection
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The targeted tumor(s) is located in liver segment 1
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The Planned Treatment Volume intended to cover the targeted tumor includes or encompasses any portion of the main portal vein, common hepatic duct, common bile duct, gallbladder or stomach/bowel
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