# Transarterial chemoembolisation (TACE)

Source: https://onco.cc/technologies/tace/  
OnCo record `tace` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A catheter threaded into the artery feeding a liver tumour delivers chemotherapy and then blocks the vessel, starving the tumour from inside.

## Summary

Standard of care for intermediate-stage (BCLC B) HCC for four decades (Llovet 2002, Lo 2002). Conventional TACE uses lipiodol-chemotherapy emulsion; DEB-TACE uses drug-eluting beads. Since 2024 three phase 3 trials (EMERALD-1, LEAP-012, EMERALD-3) show that adding systemic immunotherapy and anti-VEGF therapy to TACE prolongs progression-free survival, though overall-survival benefit is unproven (LEAP-012 final OS HR 0.98). Selection matters: TACE-refractory disease should move to systemic therapy.

## Fields

- Kind: Technology
- Status: standard-of-care
- Last checked: 2026-09-07
- Principle: Selective hepatic arterial catheterisation; tumours are ~90% arterially supplied while normal liver is portal-supplied, so embolisation plus chemotherapy hits tumour preferentially.
- Since: 1980
- Strengths: Liver-directed with limited systemic toxicity; Decades of evidence and universal availability; Bridges patients to transplant
- Limitations: Post-embolisation syndrome; hepatic decompensation in poor liver function; Rarely curative; repeat sessions; OS benefit of combinations with systemic therapy not yet shown

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Transarterial_chemoembolization
- Wikipedia: https://en.wikipedia.org/wiki/Transarterial_chemoembolization

## Connected records

- cancers: [Early hepatocellular carcinoma (BCLC 0 and A)](https://onco.cc/cancers/hcc-early/), [Grade 3 well-differentiated neuroendocrine tumour](https://onco.cc/cancers/grade-3-net/), [Hepatocellular carcinoma](https://onco.cc/cancers/hcc/), [Intermediate hepatocellular carcinoma (BCLC B)](https://onco.cc/cancers/hcc-intermediate/), [Neuroendocrine tumours](https://onco.cc/cancers/neuroendocrine/), [Pancreatic neuroendocrine tumours](https://onco.cc/cancers/pancreatic-net/), [Small intestinal neuroendocrine tumours](https://onco.cc/cancers/small-intestinal-net/)
- fronts: [Chemotherapy](https://onco.cc/fronts/chemotherapy/), [Surgery & Interventional](https://onco.cc/fronts/surgery/)
- companies: [Boston Scientific](https://onco.cc/companies/boston-scientific/)
- terms: [BCLC staging](https://onco.cc/terms/bclc-staging/), [Downstaging and conversion therapy](https://onco.cc/terms/downstaging/), [Liver-directed therapy (TACE, TARE, HAI, ablation)](https://onco.cc/terms/liver-directed-therapy/), [Portal vein tumour thrombus (macrovascular invasion)](https://onco.cc/terms/portal-vein-tumour-thrombus/), [TACE (transarterial chemoembolisation)](https://onco.cc/terms/tace-term/), [TARE / SIRT (radioembolisation with yttrium-90)](https://onco.cc/terms/tare/)
- trials: [A Phase II/III Trial Comparing Transarterial Tirapazamine Embolization (TATE) With cTACE for Intermediate-stage Liver Cancer.](https://onco.cc/trials/nct06844357/), [A Study of PTX-9908 Injection for Non-resectable HCC with TACE](https://onco.cc/trials/nct03812874/), [EMERALD-1](https://onco.cc/trials/emerald-1/), [EMERALD-3](https://onco.cc/trials/emerald-3/), [LEAP-012](https://onco.cc/trials/leap-012/)
- pairings: [TACE + immunotherapy/anti-VEGF](https://onco.cc/pairings/tace-plus-systemic/)
- drugs: [Ethiodized oil](https://onco.cc/drugs/ethiodized-oil/)
- technologies: [Percutaneous hepatic perfusion (chemosaturation)](https://onco.cc/technologies/percutaneous-hepatic-perfusion/)
- roadmaps: [Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work](https://onco.cc/roadmaps/surgery-roadmap/)

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