Recent advances and applications of microspheres and nanoparticles in transarterial chemoembolization for hepatocellular carcinoma

Abstract

Transarterial chemoembolization (TACE) is a recommended treatment for patients suffering from intermediate and advanced hepatocellular carcinoma (HCC). As compared to the conventional TACE, drug‐eluting bead TACE demonstrates several advantages in terms of survival, treatment response, and adverse effects. The selection of embolic agents is critical to the success of TACE. Many studies have been performed on the modification of the structure, size, homogeneity, biocompatibility, and biodegradability of embolic agents. Continuing efforts are focused on efficient loading of versatile chemotherapeutics, controlled sizes for sufficient occlusion, real‐time detection intra‐ and post‐procedure, and multimodality imaging‐guided precise treatment. Here, we summarize recent advances and applications of microspheres and nanoparticles in TACE for HCC. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease

Hepatosellüler Karsinomda İlaç Yüklenebilir Mikroküreler ile Yapılan Transarteriyel Kemoembolizasyonun Etkinliği: Tek Merkez Deneyimi

“…There are studies comparing the treatment efficacy and complication rates according to the size of drug-eluting beads (15). Higher coagulation necrosis and complete response rates, longer overall survival, less fibrosis, and postembolization syndrome have been reported in embolization procedures performed with 100-300 μm particles compared to those undertaken with larger particles (15). However, due to the risk of severe necrosis in normal liver tissue, advanced embolization with very small particles should be avoided (11).…”

“…However, due to the risk of severe necrosis in normal liver tissue, advanced embolization with very small particles should be avoided (11). While no significant difference has been shown between large and small size particles in terms of drug release, it has been reported that small beads have a higher drug-eluting capacity due to their high surface area/volume ratio (15). Many factors such as tumor volume, size of the artery feeding the tumor, and tumor characteristics should be considered in the selection of the bead size to be used.…”

Emerging Polymer Materials in Trackable Endovascular Embolization and Cell Delivery: From Hype to Hope

“…This approach does not require ethiodol and lowers pain and systemic toxicity in the patients. Some shortcomings of DEB-TACE are permanent occlusion (due to nondegradable microspheres), a limited selection of therapeutics to load onto the microspheres, and nontraceability of microspheres during in vivo applications [ 62 ]. The development of new degradable microspheres with the ability to load more than one therapeutic candidate may expand treatment options.…”

Multimodal imaging of nano-assembled microspheres loaded with doxorubicin and Cisplatin for liver tumor therapy

“…Therefore, the visualization of drug loaded microspheres and the search for new drug carriers have become a research hotspot (Sharma et al, 2016;Liu et al, 2021;Jia et al, 2022). At present, research on the visualization of microspheres mainly focuses on X-ray and magnetic resonance imaging (MR imaging).…”

“…MR imaging is mainly achieved by introducing paramagnetic lanthanides and superparamagnetic iron oxide into the microspheres (Fidelman et al, 2002). Some researchers have also studied CT/MRI dual-imaging microspheres with both CT and MRI internal contrast agents, which have been preliminarily verified in animal experiments (Hagit et al, 2010;Jia et al, 2022;Yin et al, 2022). Although previous studies have realized the visualization of drug loaded microspheres to a certain extent, they have not comprehensively solved the monitoring of drug loaded microspheres during injection, postoperative CT and MRI reexamination, or of distribution tracking.…”