Embolotherapy for Hepatic Oncology: Current Perspectives and Future Directions

Abstract

Primary and secondary liver cancers are a major cause of mortality worldwide. Transarterial liver-directed therapy, or embolotherapy, represents an important locoregional treatment strategy for primary and secondary liver tumors. Embolotherapeutic modalities include bland embolization (transarterial embolization), chemoembolization (transarterial chemoembolization), and radioembolization or selective internal radiotherapy. A brief technical overview of embolotherapeutic modalities as well as supportive evidence for the treatment of most common primary and secondary liver tumors will be discussed in this review. Several potential future applications, including synergy with systemic therapy, interventional theranostics, and artificial intelligence will also be reviewed briefly.

CFD Simulations of Radioembolization: A Proof-of-Concept Study on the Impact of the Hepatic Artery Tree Truncation

“…When seeking to preserve as much healthy liver as possible, the aim is to advance the microcatheter as distally as possible. This allows to deliver high radiation doses via the microspheres released in the tumor-feeding arteries [2]. In this study, the site of injection of microspheres is optimal in Patient 2a, with 100% of microspheres reaching segment 8, and acceptable in the case of Patient 3 with 85% of microspheres reaching the tumoral segment (S8).…”

“…Liver cancer is one of the leading types of cancer in incidence and mortality rates worldwide [1]. Radioembolization (RE) is a safe and effective intraarterial targeted therapy for unresectable primary and secondary liver tumors and it consists in the microcatheterbased infusion of yttrium-90 (Y-90) radiolabeled microspheres that are transported in the bloodstream until they get lodged in the tumoral tissue, where they deliver high tumoricidal doses of radiation to cancer cells, while ideally sparing healthy liver parenchyma [2].…”

Targeted radionuclide therapy in endocrine-related cancers: advances in the last decade

“…For patients with liver dominant disease, intra-hepatic administration of PRRT provides a unique opportunity to target progressing disease with higher concentrations of the therapy and reduce systemic toxicity. This approach has been evaluated in patients with GEP-NETs retrospectively, showing that patients with liver-limited disease had longer median PFS and OS than those across the entire cohort of patients (33.4 and 75.8 months vs. 29 and 70 months, respectively) ( 37 , 117 ).…”