Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Chin Clin Oncol. 2024 Oct;13(5):71. doi: 10.21037/cco-24-27. Epub 2024 Oct 10.
Immune checkpoint inhibitors (ICIs) and transarterial radioembolization (TARE) are now regarded as promising and versatile therapies for hepatocellular carcinoma (HCC). Combining TARE and ICIs may offer synergistic antineoplastic effects by integrating local and systemic tumor control. This review critically discusses recent preclinical evidence supporting the TARE-ICI combination strategy, completed and ongoing clinical trials, and the challenges in identifying optimal target populations and treatment protocols.
A comprehensive literature search was conducted in multiple electronic databases (PubMed, Scopus, and Web of Science) from January 1999 to January 2024. The first part of the search was directed at identifying concluded studies regarding the TARE-ICIs combination. The second part aimed at identifying ongoing clinical trials exploring the Clinicaltrials.gov database.
The combination of TARE and ICIs is a promising strategy, supported by preclinical evidence of immune activation post-TARE and potential synergies with ICIs. Early-phase clinical trials have reported encouraging efficacy. However, significant heterogeneity exists among these studies, particularly concerning target populations and treatment schedules.
The current evidence on TARE-ICI is favorable and promising in improving outcomes of patients with HCC. Further conclusive and higher levels of evidence are pending.
免疫检查点抑制剂（ICIs）和经动脉放射性栓塞术（TARE）现在被认为是治疗肝细胞癌（HCC）的有前途且多功能的疗法。TARE 和 ICI 的联合使用可以通过整合局部和全身肿瘤控制来提供协同的抗肿瘤作用。这篇综述批判性地讨论了支持 TARE-ICI 联合策略的最近临床前证据、已完成和正在进行的临床试验，以及确定最佳目标人群和治疗方案所面临的挑战。
我们在多个电子数据库（PubMed、Scopus 和 Web of Science）中进行了全面的文献检索，检索时间从 1999 年 1 月到 2024 年 1 月。搜索的第一部分旨在确定关于 TARE-ICIs 联合治疗的已完成研究。搜索的第二部分旨在确定正在探索 Clinicaltrials.gov 数据库的临床试验。
TARE 和 ICI 的联合是一种很有前途的策略，有临床前证据表明 TARE 后会激活免疫，并且与 ICI 有潜在的协同作用。早期临床试验报告了令人鼓舞的疗效。然而，这些研究之间存在显著的异质性，特别是在目标人群和治疗方案方面。
目前关于 TARE-ICI 的证据在改善 HCC 患者的预后方面是有利的和有前途的。还需要更多的结论性和更高水平的证据。
