Subsequent Treatment after Transarterial Chemoembolization Failure/Refractoriness: A Review Based on Published...

Area of Science:

• Hepatology
• Oncology
• Interventional Radiology

Background:

• Transarterial chemoembolization (TACE) is a primary treatment for hepatocellular carcinoma (HCC).
• Repeat TACE sessions are often necessary due to insufficient tumor response but can lead to liver dysfunction and adverse events.
• This necessitates the concept of TACE failure/refractoriness.

Purpose of the Study:

• To review and summarize current evidence on various treatment modalities following TACE failure or refractoriness in HCC patients.
• To provide an overview of the outcomes associated with different subsequent therapies.

Main Methods:

• Literature review of studies investigating treatments after TACE failure/refractoriness.
• Focus on sorafenib as a recommended first-line treatment based on retrospective data.
• Inclusion of data on locoregional therapies, other targeted agents, immunotherapy (anti-PD-1/anti-PD-L1), and combination therapies.

Main Results:

• Sorafenib is a recommended first-line treatment for TACE failure/refractoriness, primarily supported by Japanese retrospective studies.
• Various other treatments, including locoregional therapies, molecular targeted agents, and immunotherapies, have been explored.
• Outcomes for these diverse subsequent treatment strategies are being investigated.

Conclusions:

• Understanding TACE failure/refractoriness is crucial for optimizing HCC management.
• Sorafenib represents a key option, but a range of other therapies are emerging for post-TACE failure treatment.
• Further research is needed to establish the efficacy and optimal sequencing of these subsequent treatments.