Transarterial chemoembolisation (TACE)
A catheter threaded into the artery feeding a liver tumour delivers chemotherapy and then blocks the vessel, starving the tumour from inside.
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.
How it works
Selective hepatic arterial catheterisation; tumours are ~90% arterially supplied while normal liver is portal-supplied, so embolisation plus chemotherapy hits tumour preferentially.
- Liver-directed with limited systemic toxicity
- Decades of evidence and universal availability
- Bridges patients to transplant
- Post-embolisation syndrome; hepatic decompensation in poor liver function
- Rarely curative; repeat sessions
- OS benefit of combinations with systemic therapy not yet shown
Latest papers
topQuery for this technology: (TITLE:"Transarterial chemoembolisation" OR ABSTRACT:"Transarterial chemoembolisation" OR TITLE:"TACE" OR ABSTRACT:"TACE") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Transarterial chemoembolisation (TACE), not a curated reading list.