Transarterial Chemoembolization Techniques for Hepatocellular Carcinoma

Transarterial Chemoembolization (TACE) is the standard of care for intermediate-stage hepatocellular carcinoma (HCC) in patients who are ineligible for surgical resection or transplantation. By exploiting the predominantly arterial blood supply of hepatic tumours, TACE delivers high concentrations of cytotoxic agents directly into the tumour vasculature while simultaneously occluding tumour feeders to induce ischaemic necrosis. Conventional TACE employs an emulsion of chemotherapeutic drugs and lipiodol, whereas drug-eluting bead (DEB) TACE provides sustained local drug release and reduced systemic exposure. Innovations in embolic materials—ranging from biodegradable micro- and nano-particles with imaging capabilities to multifunctional agents combining drug delivery with thermal or photodynamic modalities—aim to enhance locoregional control and minimise retreatment. In parallel, combinatorial strategies integrating targeted therapies or immune checkpoint inhibitors with TACE have shown promise in extending progression-free and overall survival. Despite its palliative intent, TACE remains a versatile, cost-effective intervention worldwide, with ongoing research focused on optimising patient selection, refining delivery techniques and integrating systemic agents to improve long-term outcomes.

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Transarterial Chemoembolization Techniques for Hepatocellular Carcinoma publication trend

The graph below shows the total number of articles in transarterial chemoembolization techniques for hepatocellular carcinoma across all publications each year (not limited to Nature Index journals).

Technical terms

Transarterial Chemoembolization (TACE): A locoregional procedure in which chemotherapy and embolic material are delivered via the hepatic artery to occlude tumour blood flow and concentrate cytotoxic agents within the lesion.

Drug-Eluting Beads (DEBs): Microspherical embolic particles engineered to load and gradually release chemotherapeutic drugs at the target site, reducing systemic toxicity.

Embolic Agents: Substances introduced into arterial branches to obstruct tumour-feeding vessels, induce ischaemia and potentiate the effect of delivered chemotherapy.

PD-(L)1 Inhibitors: Immune checkpoint inhibitors that block the interaction between programmed death-ligand 1 on tumour cells and its receptor on T cells, thereby restoring anti-tumour immune activity.

Progression-Free Survival (PFS): The duration during and after treatment in which a patient’s disease does not exhibit radiological or clinical signs of progression.

References

1. Transarterial chemoembolization with PD-(L)1 inhibitors plus molecular targeted therapies for hepatocellular carcinoma (CHANCE001). Signal Transduction and Targeted Therapy (2023).
2. Bench-to-bedside development of multifunctional flexible embolic agents. Theranostics (2023).
3. Conventional transarterial chemoembolization versus drug-eluting bead transarterial chemoembolization for the treatment of hepatocellular carcinoma. BMC Cancer (2015).
4. Transarterial Chemoembolization Combined With Lenvatinib Plus PD-1 Inhibitor for Advanced Hepatocellular Carcinoma: A Retrospective Cohort Study. Frontiers in Immunology (2022).