Molecular mechanisms of TACE refractoriness: Directions for improvement of the TACE procedure
Jiahao Li1, Yingnan Liu2, Ruipeng Zheng3
1Department of Interventional Therapy, The First Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China; The Public Laboratory Platform of the First Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China.
Abstract:
Transcatheter arterial chemoembolisation (TACE) is the standard of care for intermediate-stage hepatocellular carcinoma and selected patients with advanced hepatocellular carcinoma. However, TACE does not achieve a satisfactory objective response rate, and the concept of TACE refractoriness has been proposed to identify patients who do not fully benefit from TACE. Moreover, repeated TACE is necessary to obtain an optimal and sustained anti-tumour response, which may damage the patient's liver function. Therefore, studies have recently been performed to improve the effectiveness of TACE. In this review, we summarise the detailed molecular mechanisms associated with TACE responsiveness and relapse after this treatment to provide more effective targets for adjuvant therapy while helping to improve TACE regimens.
Insights
Transcatheter arterial chemoembolisation (TACE) improves outcomes for liver cancer but has limitations. Understanding TACE resistance mechanisms can guide new therapies to enhance treatment effectiveness and preserve liver function.
Area of Science:
- Hepatobiliary cancers
- Interventional oncology
- Molecular targeted therapy
Background:
- Transcatheter arterial chemoembolisation (TACE) is a primary treatment for intermediate-stage hepatocellular carcinoma (HCC).
- TACE exhibits limitations, including suboptimal response rates and the emergence of TACE refractoriness.
- Repeated TACE can impair liver function, necessitating strategies to improve its efficacy and reduce toxicity.
Purpose of the Study:
- To review the molecular mechanisms underlying TACE responsiveness and relapse in HCC.
- To identify potential molecular targets for adjuvant therapies to improve TACE outcomes.
- To inform the optimization of TACE treatment regimens for better patient benefit.
Main Methods:
- Comprehensive literature review of studies investigating TACE in HCC.
- Analysis of molecular pathways involved in TACE response and resistance.
- Synthesis of data on mechanisms of tumor relapse post-TACE.
Main Results:
- Specific molecular pathways significantly influence patient response to TACE.
- Understanding these pathways can predict TACE refractoriness and tumor recurrence.
- Identifying key molecular targets offers opportunities for novel therapeutic combinations.
Conclusions:
- Molecular insights into TACE responsiveness and relapse are crucial for advancing HCC treatment.
- Targeting identified molecular mechanisms can enhance TACE efficacy and overcome resistance.
- Optimized TACE regimens incorporating molecular-targeted adjuvant therapies hold promise for improved HCC management.
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