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Semin intervent Radiol 2023; 40(06): 515-523
DOI: 10.1055/s-0043-1777711
Review Article

Liver-Directed Therapy Combined with Systemic Therapy: Current Status and Future Directions

Shamar Young
1   Division of Interventional Radiology, Department of Medical Imaging, University of Arizona, Tucson, Arizona
,
Jack Hannallah
1   Division of Interventional Radiology, Department of Medical Imaging, University of Arizona, Tucson, Arizona
,
Dan Goldberg
1   Division of Interventional Radiology, Department of Medical Imaging, University of Arizona, Tucson, Arizona
,
Mohammad Khreiss
3   Division of Surgical Oncology, Department of Surgery, University of Arizona, Tucson, Arizona
,
Rachna Shroff
2   Division of Hematology and Oncology, Department of Medicine, University of Arizona, Tucson, Arizona
,
Junaid Arshad
2   Division of Hematology and Oncology, Department of Medicine, University of Arizona, Tucson, Arizona
,
Aaron Scott
2   Division of Hematology and Oncology, Department of Medicine, University of Arizona, Tucson, Arizona
,
Gregory Woodhead
1   Division of Interventional Radiology, Department of Medical Imaging, University of Arizona, Tucson, Arizona
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Abstract

In the past several decades, major advances in both systemic and locoregional therapies have been made for many cancer patients. This has led to modern cancer treatment algorithms frequently calling for active interventions by multiple subspecialists at the same time. One of the areas where this can be clearly seen is the concomitant use of locoregional and systemic therapies in patients with primary or secondary cancers of the liver. These combined algorithms have gained favor over the last decade and are largely focused on the allure of the combined ability to control systemic disease while at the same time addressing refractory/resistant clonal populations. While the general concept has gained favor and is likely to only increase in popularity with the continued establishment of viable immunotherapy treatments, for many patients questions remain. Lingering concerns over the increase in toxicity when combining treatment methods, patient selection, and sequencing remain for multiple cancer patient populations. While further work remains, some of these questions have been addressed in the literature. This article reviews the available data on three commonly treated primary and secondary cancers of the liver, namely, hepatocellular carcinoma, cholangiocarcinoma, and metastatic colorectal cancer. Furthermore, strengths and weaknesses are reviewed and future directions are discussed.

Keywords

transarterial radioembolization - thermal ablation - transarterial chemoembolization - immunotherapy - metastatic colorectal cancer - intrahepatic cholangiocarcinoma - hepatocellular carcinoma - interventional radiology


Publication History

Article published online:
24 January 2024

© 2023. Thieme. All rights reserved.

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