Radioembolization for Intermediate-Stage Hepatocellular Carcinoma Maintains Liver Function and Permits Systemic Therapy at Progression

Ranganathan, Srirajkumar; Gabr, Ahmed; Entezari, Pouya; Riaz, Ahsun; Desai, Kush; Thornburg, Bartley; Kulik, Laura; Kalyan, Aparna; Salem, Riad; Lewandowski, Robert J.

doi:10.1016/j.jvir.2022.11.036

Cited by 8 publications

(3 citation statements)

References 12 publications

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“…However, a recent study evaluated the frequency with which TARE reduced the liver health of a patient such that systemic therapies would be prohibited, and found that it was infrequent. 59 While not evaluating the efficacy of combining immunotherapies and TARE, several studies have evaluated the ability of TARE to modulate the immune system. [60][61][62][63][64] Early studies have demonstrated a positive effect on the tumor microenvironment and peripheral monocytes after TARE in HCC patients.…”

Section: Transarterial Radioembolization and Systemic Therapiesmentioning

confidence: 99%

“…One consistent concern has been the ability to combine these approaches safely, without raising the toxicity level to a prohibitive level; however, multiple investigations across several different cancers have assuaged these fears. 1,2,57,59 Still, further work is needed to determine much of the bedrock principles in which these combination therapies should be built.…”

Section: Future Directionsmentioning

confidence: 99%

Section: Hepatocellular Carcinomamentioning

confidence: 99%

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Liver-Directed Therapy Combined with Systemic Therapy: Current Status and Future Directions

Young,

Hannallah,

Goldberg

et al. 2023

Semin intervent Radiol

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In the past several decades, major advances in both systemic and locoregional therapies have been made for many cancer patients. This has led to modern cancer treatment algorithms frequently calling for active interventions by multiple subspecialists at the same time. One of the areas where this can be clearly seen is the concomitant use of locoregional and systemic therapies in patients with primary or secondary cancers of the liver. These combined algorithms have gained favor over the last decade and are largely focused on the allure of the combined ability to control systemic disease while at the same time addressing refractory/resistant clonal populations. While the general concept has gained favor and is likely to only increase in popularity with the continued establishment of viable immunotherapy treatments, for many patients questions remain. Lingering concerns over the increase in toxicity when combining treatment methods, patient selection, and sequencing remain for multiple cancer patient populations. While further work remains, some of these questions have been addressed in the literature. This article reviews the available data on three commonly treated primary and secondary cancers of the liver, namely, hepatocellular carcinoma, cholangiocarcinoma, and metastatic colorectal cancer. Furthermore, strengths and weaknesses are reviewed and future directions are discussed.

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