Interventional Oncology in Hepatocellular Carcinoma

Abstract

The clinical management of hepatocellular carcinoma has evolved greatly in the last decade mostly through recent technical innovations. In particular, the application of cutting edge image guidance has led to minimally invasive solutions for complex clinical problems and rapid advances in the field of interventional oncology. Many image-guided therapies, such as transarterial chemoembolization and radiofrequency ablation have meanwhile been fully integrated into interdisciplinary clinical practice, while others are currently being investigated. This review will summarize and evaluate the most relevant completed and ongoing clinical trials, provide a synopsis of recent innovations in the field of intra-procedural imaging and tumor response assessment, and offer an outlook on new technologies, such as radiopaque embolic materials. In addition, combination therapies consisting of loco-regional therapies and systemic molecular targeted agents (e.g., sorafenib) remains of major interest to the field and will also be discussed. Finally, we will address the many substantial advances in immune response pathways that have been related to the systemic effects of loco-regional therapies. Knowledge of these new developments is crucial as they continue to shape the future of cancer treatment, further establishing interventional oncology along with surgical, medical, and radiation oncology as the 4th pillar of cancer care.

A single‐institution pediatric and young adult interventional oncology collaborative: Novel therapeutic options for relapsed/refractory solid tumors

“…For adults, and to a limited extent for children, IO‐guided therapies have proven to be a valuable adjunct to systemic therapy, a bridge to definitive local control, a tool to slow disease progression, and a mechanism by which to provide symptom relief. 6 , 7 The translation of IO methodologies to pediatric patients has been slow to evolve due to generally favorable upfront responses to systemic therapy and local control, limitations in the development and approval of new devices for use in children, pediatric patient size limitations, and a paucity of interventional radiologists trained in pediatrics. 8 As such, little is known about the application of these techniques for pediatric patients beyond isolated reports or small series.…”

Preparation, Synergism, and Biocompatibility of in situ Liquid Crystals Loaded with Sinomenine and 5-Fluorouracil for Treatment of Liver Cancer

“…Currently, hepatic resection is the main treatment for patients with early-stage HCC, while transarterial chemoembolization (TACE) is preferred for patients with middle- and advanced-stage tumors; 3 however, most traditional hepatic artery embolization agents have disadvantages, including low embolic selectivity, incomplete embolization, and insufficient embolization time, among others. 4 , 5 Phytantriol (PYT) 6 , 7 is an amphiphilic molecule with both hydrophilic hydroxyl groups and hydrophobic carbon chains. When PYT is dispersed in a small amount of water, a very low viscosity magnetic isotropic solution is formed, referred to as a precursor solution, which has the advantages of good mobility and easy injection; however, when PYT is dispersed in sufficient water and other organic solvents, it can form a high viscosity, rigid liquid crystal gel, which is non-toxic and biocompatible.…”