Recent Advances on Polymeric Beads or Hydrogels as Embolization Agents for Improved Transcatheter Arterial Chemoembolization (TACE)

Abstract

Transcatheter arterial chemoembolization (TACE), aiming to block the hepatic artery for inhibiting tumor blood supply, became a popular therapy for hepatocellular carcinoma (HCC) patients. Traditional TACE formulation of anticancer drug emulsion in ethiodized oil (i.e., Lipiodol ® ) and gelatin sponge (i.e., Gelfoam ® ) had drawbacks on patient tolerance and resulted in undesired systemic toxicity, which were both significantly improved by polymeric beads, microparticles, or hydrogels by taking advantage of the elegant design of biocompatible or biodegradable polymers, especially amphiphilic polymers or polymers with both hydrophilic and hydrophobic chains, which could self-assemble into proposed microspheres or hydrogels. In this review, we aimed to summarize recent advances on polymeric embolization beads or hydrogels as TACE agents, with emphasis on their material basis of polymer architectures, which are important but have not yet been comprehensively summarized.

Interventional radiology for liver diseases

“…Innovations in bead delivery such as radiopaque beads (DC Bead LUMI), beads in combination with Lipiodol or steerable microcatheters (swingNINA®, Merit), anti-reflux mechanism (Surefire, TriSalus Life Science; SeQure, Guerbet), or underpressure inducing balloon microcatheter (Occlusafe, Terumo) increase safety but impact on tumor response is still investigational [ 23 – 26 ]. Intriguing for the future are composite microbeads, made of magnetic nanoparticles and polymeric matrix microspheres that may induce tumor ablation effects upon application of alternating magnetic field [ 27 ].…”

Technical update on transcatheter arterial chemoembolization

“…Standardization of type of TACE, size of bead, and the type and volume of a chemotherapy agent is not yet available. Magnetic nanoparticle as a carrier is ongoing research [42] .…”

Efficacy and safety of endovascular brachytherapy combined with transarterial chemoembolization for the treatment of hepatocellular carcinoma patients with type III or IV portal vein tumor thrombosis

“…The embolization method of TACE was also modified in our study to further improve its efficacy. Conventional TACE (c-TACE) formulation of ethiodized oil (such as Lipiodol®) and gelatin sponge (such as Gelfoam®) had drawbacks on patient tolerance and resulted in undesired systemic toxicity [ 44 ]. Furthermore, more than half of the enrolled patients ( n = 34, 63.0%) had arterioportal fistulas, which could further increase false embolism.…”