Transarterial chemoembolization for the treatment of hepatocellular carcinoma: a review

Transarterial chemoembolization for the treatment of hepatocellular carcinoma: a review Rodolfo Sacco,1 Gherardo Tapete,1 Natalia Simonetti,1 Rossella Sellitri,1 Veronica Natali,1 Sara Melissari,1 Giuseppe Cabibbo,2 Lilia Biscaglia,3 Giampaolo Bresci,1 Luca Giacomelli4 1Department of Gastroenterology, Pisa University Hospital, Pisa, 2University of Palermo, Palermo, 3Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, 4Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy Abstract: According to the current European Association for the Study of Liver guidelines, transarterial chemoembolization (TACE) is the recommended first-line therapy for patients with intermediate-stage (Barcelona Clinic Liver Cancer-B class) hepatocellular carcinoma (HCC). The efficacy of this therapy is supported by robust evidence; however, there is still a lack of standardization in treatment methodology, and TACE protocols are widely variable. Moreover, TACE can be associated with a number of contraindications. Despite these limitations, research on TACE is still ongoing with the aim of optimizing the use of this methodology in the current management of HCC. In particular, TACE represents a control in comparative studies, and it is currently being investigated in combination schemes, for example, with sorafenib. In this review, we briefly describe the current scenario and the clinical innovations regarding TACE for the treatment of HCC. Keywords: TACE, HCC, BCLC-B, sorafenib