Int J Gastrointest Interv.  2021 Oct;10(4):183-188. 10.18528/ijgii210046.

Current role of systemic therapy in transarterial chemotherapyrefractory hepatocellular carcinoma patients

Affiliations
  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 2Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
  • 3Yonsei Liver Center, Severance Hospital, Seoul, Korea

Abstract

Transarterial chemotherapy (TACE) is the standard treatment for patients with intermediate-stage hepatocellular carcinoma (HCC), defined as large, unresectable, or multinodular HCC in patients with good functional performance. The definition of TACE refractoriness is not well established. Generally, TACE refractoriness is defined as an insufficient response after two or more consecutive TACE. An increase in the number of liver lesions, continuously elevated tumor markers, vascular invasion, and extrahepatic spread also suggest TACE refractoriness. Timely switching to systemic therapy for TACE refractoriness should be considered to improve the outcome. Although data are sparse, the combination of anti-angiogenic and immune checkpoint inhibitor therapies shows promise for TACE-refractory patients. In this article, we review the role of systemic therapy in TACErefractory patients with HCC.

Keyword

Hepatocellular carcinoma; Refractoriness; Systemic therapy; Transarterial chemotherapy
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