Trans-arterial chemoembolization as a therapy for liver tumours: New clinical developments and suggestions for combination with angiogenesis inhibitors.
The liver is the primary site of metastases for many malignancies. Gastrointestinal cancers are especially prone to spread to the liver and other tumours, as breast cancer and melanoma often spread to the liver. On the other hand, hepatocellular cancer (HCC) is the fifth most common malignancy in the world due to its common etiology from chronic liver damage caused by hepatitis or cirrhosis. Treatments of liver tumours vary according to histology and liver invasion and until now trans-arterial chemoembolization (TACE) has represented a main approach in the therapy of liver tumours. This review takes into consideration: (i) the background to utilizing TACE in liver tumours; (ii) TACE methods and the biological rationale for utilizing chemotherapeutic agents coated to a new micro-particle such as DC-Beads and HepaSphere; (iii) clinical experiences employing TACE in different liver tumours; (iv) the pivotal role of angiogenesis and hypoxia-induced angiogenesis following TACE with special references to HCC. Finally, the rationale for the combination of TACE with angiogenesis inhibitors is also discussed.
Interventional Radiology Unit, Integrated Section of Medical Oncology, National Cancer Institute Giovanni Paolo II, Bari, Italy. rosavet@libero.it
C Damiano
CD
Gadaleta
Girolamo
G
Ranieri
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000818:Animals; D001650:Bile Duct Neoplasms / Q000628:therapy; D001653:Bile Ducts, Intrahepatic; D001943:Breast Neoplasms / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000628:therapy; D016461:Chemoembolization, Therapeutic; D018281:Cholangiocarcinoma / Q000628:therapy; D015179:Colorectal Neoplasms / Q000473:pathology; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D004701:Endocrine Gland Neoplasms / Q000473:pathology; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000628:therapy*; D008297:Male; D008545:Melanoma / Q000473:pathology; D008863:Microspheres; D014604:Uveal Neoplasms / Q000473:pathology; D000098943:Uveal Melanoma
D020533:Angiogenesis Inhibitors