Thierry de Baere, Lambros Tselikas, Frederic Deschamps, Valerie Boige, Michel Ducreux, Antoine Hollebecque
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Advances in transarterial therapies for hepatocellular carcinoma: is novel technology leading to better outcomes?
Conventional transarterial chemoembolization (c-TACE) was validated in 2002 for intermediate stage hepatocellular carcinoma (HCC). Recent improvements in overall survival after c-TACE in HCC is linked to both better patient selection, and improvement in treatment technologies: catheter, image guidance and new drug delivery platforms. Drug eluting beads (DEBs) demonstrated a benefit over c-TACE in pharmacokinetic studies; however, two randomized studies comparing c-TACE and DEB-TACE demonstrated no benefit of DEB-TACE in response rate or overall survival. Delivery platforms loaded with yttrium-90 deliver selective internal radiation therapy, which opens a new field of therapy for HCC. Future improvement in intra-arterial therapies will include resorbable loadable embolic material, new emulsion used for c-TACE and platforms releasing multikinase inhibitors.
期刊介绍:
Primary liver cancer is the sixth most common cancer in the world, and the third most common cause of death from malignant disease. Traditionally more common in developing countries, hepatocellular carcinoma is becoming increasingly prevalent in the Western world, primarily due to an increase in hepatitis C virus infection. Emerging risk factors, such as non-alcoholic fatty liver disease and obesity are also of concern for the future. In addition, metastatic tumors of the liver are more common than primary disease. Some studies report hepatic metastases in as many as 40 to 50% of adult patients with extrahepatic primary tumors. Hepatic Oncology publishes original research studies and reviews addressing preventive, diagnostic and therapeutic approaches to all types of cancer of the liver, in both the adult and pediatric populations. The journal also highlights significant advances in basic and translational research, and places them in context for future therapy. Hepatic Oncology provides a forum to report and debate all aspects of cancer of the liver and bile ducts. The journal publishes original research studies, full reviews and commentaries, with all articles subject to independent review by a minimum of three independent experts. Unsolicited article proposals are welcomed and authors are required to comply fully with the journal''s Disclosure & Conflict of Interest Policy as well as major publishing guidelines, including ICMJE and GPP3.