US Transarterial Chemoembolization (TACE) News

Here's a summary of recent news concerning Transarterial Chemoembolization (TACE) in the US, primarily focusing on its application in treating Hepatocellular Carcinoma (HCC), the most common type of liver cancer:

Emerging Combination Therapies Show Promise:

• Lenvatinib and Pembrolizumab with TACE: A recent phase 3 study (LEAP-012) demonstrated that combining the targeted therapy lenvatinib and the immunotherapy drug pembrolizumab with TACE significantly improved progression-free survival (PFS) in patients with unresectable, non-metastatic HCC compared to TACE alone. There was also a trend towards improved overall survival. This combination is anticipated to become a new standard of care.   
• Durvalumab and Bevacizumab with TACE: The EMERALD-1 Phase III trial showed that adding the immunotherapy drug durvalumab and the angiogenesis inhibitor bevacizumab to TACE resulted in a statistically significant and clinically meaningful improvement in PFS compared to TACE alone in patients with HCC eligible for embolization.   
• Camrelizumab and Apatinib with TACE: Results from the phase 2 CARES-005 trial indicated that combining the immunotherapy drug camrelizumab and the tyrosine kinase inhibitor apatinib with TACE significantly improved PFS in patients with unresectable HCC eligible for embolization compared to TACE alone.   

TACE Remains a Cornerstone Treatment:

• TACE, a procedure developed in Japan in 1983, involves delivering chemotherapy drugs directly to the liver tumor via a catheter in the hepatic artery, followed by blocking the artery to trap the drugs within the tumor. It has been a standard of care for unresectable, non-metastatic HCC.   
• Despite the emergence of systemic therapies, TACE continues to be a crucial locoregional treatment option for intermediate-stage HCC and as a component of combination therapies.   

Challenges and Considerations:

• While combination therapies show great potential, researchers continue to explore optimal treatment sequences and patient selection criteria.   
• Concerns exist about potential side effects associated with combination therapies compared to TACE alone, necessitating careful monitoring and management.   

Technological Aspects:

• Different TACE modalities, such as conventional TACE (cTACE) and drug-eluting bead TACE (DEB-TACE), are used. Recent analysis from the EMERALD-1 trial suggests that the benefit of adding durvalumab and bevacizumab to TACE was observed regardless of the TACE modality used.   

Overall Trends:

• The focus in treating unresectable HCC is shifting towards combining locoregional therapies like TACE with systemic agents, including targeted therapies and immunotherapies, to improve patient outcomes.   
   
• Ongoing research aims to refine these combination strategies and identify biomarkers to personalize treatment approaches for patients with HCC.