Limitations and Possibilities of Transarterial Chemotherapeutic Treatment of Hepatocellular Carcinoma
Because diagnostic tools for discriminating between hepatocellular carcinoma (HCC) and advanced cirrhosis are poor, HCC is often detected in a stage where transarterial chemoembolization (TACE) is the best treatment option, even though it provides a poor survival gain. Despite having been used world...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-12-01
|
| Series: | International Journal of Molecular Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1422-0067/22/23/13051 |
| _version_ | 1797507732418330624 |
|---|---|
| author | Charlotte Ebeling Barbier Femke Heindryckx Hans Lennernäs |
| author_facet | Charlotte Ebeling Barbier Femke Heindryckx Hans Lennernäs |
| author_sort | Charlotte Ebeling Barbier |
| collection | DOAJ |
| description | Because diagnostic tools for discriminating between hepatocellular carcinoma (HCC) and advanced cirrhosis are poor, HCC is often detected in a stage where transarterial chemoembolization (TACE) is the best treatment option, even though it provides a poor survival gain. Despite having been used worldwide for several decades, TACE still has many limitations. First, there is a vast heterogeneity in the cellular composition and metabolism of HCCs as well as in the patient population, which renders it difficult to identify patients who would benefit from TACE. Often the delivered drug does not penetrate sufficiently selectively and deeply into the tumour and the drug delivery system is not releasing the drug at an optimal clinical rate. In addition, therapeutic effectiveness is limited by the crosstalk between the tumour cells and components of the cirrhotic tumour microenvironment. To improve this widely used treatment of one of our most common and deadly cancers, we need to better understand the complex interactions between drug delivery, local pharmacology, tumour targeting mechanisms, liver pathophysiology, patient and tumour heterogeneity, and resistance mechanisms. This review provides a novel and important overview of clinical data and discusses the role of the tumour microenvironment and lymphatic system in the cirrhotic liver, its potential response to TACE, and current and possible novel DDSs for locoregional treatment. |
| first_indexed | 2024-03-10T04:52:38Z |
| format | Article |
| id | doaj.art-bf6865e4921d4af8881a173fa8026291 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-10T04:52:38Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-bf6865e4921d4af8881a173fa80262912023-11-23T02:32:21ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672021-12-0122231305110.3390/ijms222313051Limitations and Possibilities of Transarterial Chemotherapeutic Treatment of Hepatocellular CarcinomaCharlotte Ebeling Barbier0Femke Heindryckx1Hans Lennernäs2Department of Surgical Sciences, Section of Radiology, Uppsala University, 752 36 Uppsala, SwedenDepartment of Medical Cell Biology, Uppsala University, 751 23 Uppsala, SwedenDepartment of Pharmaceutical Biosciences, Uppsala University, 751 23 Uppsala, SwedenBecause diagnostic tools for discriminating between hepatocellular carcinoma (HCC) and advanced cirrhosis are poor, HCC is often detected in a stage where transarterial chemoembolization (TACE) is the best treatment option, even though it provides a poor survival gain. Despite having been used worldwide for several decades, TACE still has many limitations. First, there is a vast heterogeneity in the cellular composition and metabolism of HCCs as well as in the patient population, which renders it difficult to identify patients who would benefit from TACE. Often the delivered drug does not penetrate sufficiently selectively and deeply into the tumour and the drug delivery system is not releasing the drug at an optimal clinical rate. In addition, therapeutic effectiveness is limited by the crosstalk between the tumour cells and components of the cirrhotic tumour microenvironment. To improve this widely used treatment of one of our most common and deadly cancers, we need to better understand the complex interactions between drug delivery, local pharmacology, tumour targeting mechanisms, liver pathophysiology, patient and tumour heterogeneity, and resistance mechanisms. This review provides a novel and important overview of clinical data and discusses the role of the tumour microenvironment and lymphatic system in the cirrhotic liver, its potential response to TACE, and current and possible novel DDSs for locoregional treatment.https://www.mdpi.com/1422-0067/22/23/13051hepatocellular carcinomatransarterial chemoembolizationdrug delivery systemstumour microenvironmentanthracyclines |
| spellingShingle | Charlotte Ebeling Barbier Femke Heindryckx Hans Lennernäs Limitations and Possibilities of Transarterial Chemotherapeutic Treatment of Hepatocellular Carcinoma International Journal of Molecular Sciences hepatocellular carcinoma transarterial chemoembolization drug delivery systems tumour microenvironment anthracyclines |
| title | Limitations and Possibilities of Transarterial Chemotherapeutic Treatment of Hepatocellular Carcinoma |
| title_full | Limitations and Possibilities of Transarterial Chemotherapeutic Treatment of Hepatocellular Carcinoma |
| title_fullStr | Limitations and Possibilities of Transarterial Chemotherapeutic Treatment of Hepatocellular Carcinoma |
| title_full_unstemmed | Limitations and Possibilities of Transarterial Chemotherapeutic Treatment of Hepatocellular Carcinoma |
| title_short | Limitations and Possibilities of Transarterial Chemotherapeutic Treatment of Hepatocellular Carcinoma |
| title_sort | limitations and possibilities of transarterial chemotherapeutic treatment of hepatocellular carcinoma |
| topic | hepatocellular carcinoma transarterial chemoembolization drug delivery systems tumour microenvironment anthracyclines |
| url | https://www.mdpi.com/1422-0067/22/23/13051 |
| work_keys_str_mv | AT charlotteebelingbarbier limitationsandpossibilitiesoftransarterialchemotherapeutictreatmentofhepatocellularcarcinoma AT femkeheindryckx limitationsandpossibilitiesoftransarterialchemotherapeutictreatmentofhepatocellularcarcinoma AT hanslennernas limitationsandpossibilitiesoftransarterialchemotherapeutictreatmentofhepatocellularcarcinoma |