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Locoregional therapy (LRT) including percutaneous ablation, transarterial chemoembolization (TACE), and transarterial radioembolization (TARE) have become the mainstay of treatment for patients with early- to intermediate-stage (Barcelona Clinic Liver Cancer [BCLC]) Hepatocellular Carcinoma (HCC). Newer systemic therapy options, particularly immunotherapy-based combinations, have become first-line recommendations in patients with advanced-stage disease. They have also shown promise in patients with intermediate-stage HCC. However, given the potential for conversion into curative intent therapy candidacy, patients with intermediate-stage disease should be considered first for LRT as recommended by the current BCLC staging. Patients with advanced-stage disease could also benefit from debulking and potential downstaging with LRT prior to systemic therapy initiation and should at least be considered for LRT at the time of evaluation for systemic therapy.

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Should All Patients Be Considered for Locoregional Therapy Before Systemic Therapy?

  • 章节

  • 发表日期：

    2025年

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  • Jordan Tasse,
  • Bulent Arslan

摘要

Locoregional therapy (LRT) including percutaneous ablation, transarterial chemoembolization (TACE), and transarterial radioembolization (TARE) have become the mainstay of treatment for patients with early- to intermediate-stage (Barcelona Clinic Liver Cancer [BCLC]) Hepatocellular Carcinoma (HCC). Newer systemic therapy options, particularly immunotherapy-based combinations, have become first-line recommendations in patients with advanced-stage disease. They have also shown promise in patients with intermediate-stage HCC. However, given the potential for conversion into curative intent therapy candidacy, patients with intermediate-stage disease should be considered first for LRT as recommended by the current BCLC staging. Patients with advanced-stage disease could also benefit from debulking and potential downstaging with LRT prior to systemic therapy initiation and should at least be considered for LRT at the time of evaluation for systemic therapy.