Chemoembolization Beyond Hepatocellular Carcinoma: What Tumors Can We Treat and When?

Overview

Journal Semin Intervent Radiol

Specialty Radiology

Date 2024 Mar 18

PMID 38495263

Authors

Daniel M DePietro

Xin Li

Susan M Shamimi-Noori

Affiliations

Soon will be listed here.

Abstract

Liver metastases are the most common malignancy found in the liver and are 20 to 40 times more common than primary hepatic tumors, including hepatocellular carcinoma. Patients with liver metastases often present with advanced disease and are not eligible for curative-intent surgery or ablative techniques. The unique hepatic arterial blood supply of liver metastases allows interventional radiologists to target these tumors with transarterial therapies. Transarterial chemoembolization (TACE) has been studied in the treatment of liver metastases originating from a variety of primary malignancies and has demonstrated benefits in terms of hepatic progression-free survival, overall survival, and symptomatic relief, among other benefits. Depending on the primary tumor from which they originate, liver metastases may have different indications for TACE, may utilize different TACE regimens and techniques, and may result in different post-procedural outcomes. This review offers an overview of TACE techniques and specific considerations in the treatment of liver metastases, provides an in-depth review of TACE in the treatment of liver metastases originating from colorectal cancer, neuroendocrine tumor, and uveal melanoma, which represent some of the many tumors beyond hepatocellular carcinoma that can be treated by TACE, and summarizes data regarding when one should consider TACE in their treatment algorithms.

References

Chang J, Charalel R, Noda C, Ramaswamy R, Kim S, Darcy M . Liver-dominant Breast Cancer Metastasis: A Comparative Outcomes Study of Chemoembolization Radioembolization. Anticancer Res. 2018; 38(5):3063-3068. DOI: 10.21873/anticanres.12563. View

Shamimi-Noori S, Gonsalves C, Shaw C . Metastatic Liver Disease: Indications for Locoregional Therapy and Supporting Data. Semin Intervent Radiol. 2017; 34(2):145-166. PMC: 5453777. DOI: 10.1055/s-0037-1602712. View

McLaughlin C, Wu X, Jemal A, Martin H, Roche L, Chen V . Incidence of noncutaneous melanomas in the U.S. Cancer. 2005; 103(5):1000-7. DOI: 10.1002/cncr.20866. View

Chamberlain R, Canes D, Brown K, Saltz L, Jarnagin W, Fong Y . Hepatic neuroendocrine metastases: does intervention alter outcomes?. J Am Coll Surg. 2000; 190(4):432-45. DOI: 10.1016/s1072-7515(00)00222-2. View

Yamamoto A, Chervoneva I, Sullivan K, Eschelman D, Gonsalves C, Mastrangelo M . High-dose immunoembolization: survival benefit in patients with hepatic metastases from uveal melanoma. Radiology. 2009; 252(1):290-8. PMC: 6944074. DOI: 10.1148/radiol.2521081252. View

Chen J, Wileyto E, Soulen M . Randomized Embolization Trial for NeuroEndocrine Tumor Metastases to the Liver (RETNET): study protocol for a randomized controlled trial. Trials. 2018; 19(1):390. PMC: 6050671. DOI: 10.1186/s13063-018-2782-5. View

de Baere T, Zhang X, Aubert B, Harry G, Lagrange C, Ropers J . Quantification of tumor uptake of iodized oils and emulsions of iodized oils: experimental study. Radiology. 1996; 201(3):731-5. DOI: 10.1148/radiology.201.3.8939223. View

Brown K, Do R, Gonen M, Covey A, Getrajdman G, Sofocleous C . Randomized Trial of Hepatic Artery Embolization for Hepatocellular Carcinoma Using Doxorubicin-Eluting Microspheres Compared With Embolization With Microspheres Alone. J Clin Oncol. 2016; 34(17):2046-53. PMC: 4966514. DOI: 10.1200/JCO.2015.64.0821. View

Lucatelli P, Burrel M, Guiu B, De Rubeis G, van Delden O, Helmberger T . CIRSE Standards of Practice on Hepatic Transarterial Chemoembolisation. Cardiovasc Intervent Radiol. 2021; 44(12):1851-1867. DOI: 10.1007/s00270-021-02968-1. View

10.

Gaba R . Chemoembolization practice patterns and technical methods among interventional radiologists: results of an online survey. AJR Am J Roentgenol. 2012; 198(3):692-9. DOI: 10.2214/AJR.11.7066. View

11.

Avritscher R, Gupta S . Gastrointestinal stromal tumor: role of interventional radiology in diagnosis and treatment. Hematol Oncol Clin North Am. 2009; 23(1):129-37, ix. DOI: 10.1016/j.hoc.2008.11.002. View

12.

Kim W, Clark T, Baum R, Soulen M . Risk factors for liver abscess formation after hepatic chemoembolization. J Vasc Interv Radiol. 2001; 12(8):965-8. DOI: 10.1016/s1051-0443(07)61577-2. View

13.

Morgan R, Pommier S, Pommier R . Expanded criteria for debulking of liver metastasis also apply to pancreatic neuroendocrine tumors. Surgery. 2017; 163(1):218-225. DOI: 10.1016/j.surg.2017.05.030. View

14.

Maire F, Lombard-Bohas C, OToole D, Vullierme M, Rebours V, Couvelard A . Hepatic arterial embolization versus chemoembolization in the treatment of liver metastases from well-differentiated midgut endocrine tumors: a prospective randomized study. Neuroendocrinology. 2012; 96(4):294-300. DOI: 10.1159/000336941. View

15.

Yao J, Hassan M, Phan A, Dagohoy C, Leary C, Mares J . One hundred years after "carcinoid": epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008; 26(18):3063-72. DOI: 10.1200/JCO.2007.15.4377. View

16.

Lewandowski R, Memon K, Mulcahy M, Hickey R, Marshall K, Williams M . Twelve-year experience of radioembolization for colorectal hepatic metastases in 214 patients: survival by era and chemotherapy. Eur J Nucl Med Mol Imaging. 2014; 41(10):1861-9. DOI: 10.1007/s00259-014-2799-2. View

17.

Currie B, Nadolski G, Mondschein J, Dagli M, Sudheendra D, William Stavropoulos S . Chronic Hepatotoxicity in Patients with Metastatic Neuroendocrine Tumor: Transarterial Chemoembolization versus Transarterial Radioembolization. J Vasc Interv Radiol. 2020; 31(10):1627-1635. DOI: 10.1016/j.jvir.2020.05.019. View

18.

Mariani P, Piperno-Neumann S, Servois V, Berry M, Dorval T, Plancher C . Surgical management of liver metastases from uveal melanoma: 16 years' experience at the Institut Curie. Eur J Surg Oncol. 2009; 35(11):1192-7. DOI: 10.1016/j.ejso.2009.02.016. View

19.

Aliberti C, Fiorentini G, Muzzio P, Pomerri F, Tilli M, Dallara S . Trans-arterial chemoembolization of metastatic colorectal carcinoma to the liver adopting DC Bead®, drug-eluting bead loaded with irinotecan: results of a phase II clinical study. Anticancer Res. 2011; 31(12):4581-7. View

20.

Saxena A, Meteling B, Kapoor J, Golani S, Morris D, Bester L . Is yttrium-90 radioembolization a viable treatment option for unresectable, chemorefractory colorectal cancer liver metastases? A large single-center experience of 302 patients. Ann Surg Oncol. 2014; 22(3):794-802. DOI: 10.1245/s10434-014-4164-x. View