Advances in Radioembolization for Liver Cancer

Radioembolization, most commonly in the form of transarterial delivery of microspheres embedded or loaded with yttrium-90, has evolved to become a highly effective and versatile treatment modality for both primary and metastatic liver cancers. Refinements in patient selection and dosimetry have advanced this therapy as a frontline choice in many clinical scenarios. Despite this, certain limitations restrain the full potential of this therapy and its application to liver cancer and solid tumors in other organs. Recent preclinical advances in image-guided delivery of cancer therapeutics seek to improve upon the existing platform of radioembolization. These include codelivery of agents that harness untapped tumoricidal sources of radionuclides including nanophotosensitizers, chemotherapeutics, immune adjuvants, and photothermal agents. Alternative radionuclides such as alpha emitters can also be locally delivered using image guidance. This review details some of these preclinical advances.