Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain.
Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain; Institute of Industrial Pharmacy, Complutense University of Madrid, Madrid, Spain.
Acta Biomater. 2022 Sep 1;149:1-15. doi: 10.1016/j.actbio.2022.07.019. Epub 2022 Jul 13.
Embolization with microspheres is a therapeutic strategy based on the selective occlusion of the blood vessels feeding a tumor. This procedure is intraarterially performed in the clinical setting for the treatment of liver cancer. The practice has evolved over the last decade through the incorporation of drug loading ability, biodegradability and imageability with the subsequent added functionality for the physicians and improved clinical outcomes for the patients. This review highlights the evolution of the embolization systems developed through the analysis of the marketed embolic microspheres for the treatment of malignant hepatocellular carcinoma, namely the most predominant form of liver cancer. Embolic microspheres for the distinct modalities of embolization (i.e., bland embolization, chemoembolization and radioembolization) are here comprehensively compiled with emphasis on material characteristics and their impact on microsphere performance. Moreover, the future application of the embolics under clinical investigation is discussed along with the scientific and regulatory challenges ahead in the field. STATEMENT OF SIGNIFICANCE: Embolization therapy with microspheres is currently used in the clinical setting for the treatment of most liver cancer conditions. The progressive development of added functionalities on embolic microspheres (such as biodegradability, imageability or drug and radiopharmaceutical loading capability) provides further benefit to patients and widens the therapeutic armamentarium for physicians towards truly personalized therapies. Therefore, it is important to analyze the possibilities that advanced biomaterials offer in the field from a clinical translational perspective to outline the future trends in therapeutic embolization.
栓塞微球是一种基于选择性阻断肿瘤供血血管的治疗策略。这种方法在临床环境中经动脉内进行，用于治疗肝癌。在过去十年中，通过将载药能力、生物降解性和可成像性与随后为医生增加的功能相结合，该实践得到了发展，并为患者带来了更好的临床效果。本综述通过分析用于治疗恶性肝细胞癌（即最常见的肝癌形式）的市售栓塞微球，强调了栓塞系统的发展演变。针对不同的栓塞方式（即单纯栓塞、化疗栓塞和放射性栓塞）的栓塞微球在这里进行了全面汇编，重点介绍了材料特性及其对微球性能的影响。此外，还讨论了临床研究中正在应用的栓塞剂的未来应用以及该领域面临的科学和监管挑战。
微球栓塞疗法目前已在临床环境中用于治疗大多数肝癌疾病。栓塞微球的附加功能（如生物降解性、可成像性或药物和放射性药物载药能力）的不断发展为患者提供了更多益处，并为医生提供了更广泛的治疗手段，以实现真正的个性化治疗。因此，从临床转化的角度分析先进生物材料在该领域提供的可能性，以勾勒出治疗性栓塞的未来趋势非常重要。
