scholarly journals Transarterial Radioembolization (TARE) Agents beyond 90Y-Microspheres

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
C. Bouvry ◽  
X. Palard ◽  
J. Edeline ◽  
V. Ardisson ◽  
P. Loyer ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Options ◽  
Hepatic Metastases ◽  
Liver Malignancies ◽  
Liver Tumours ◽  
Alternative Technologies ◽  
Transarterial Radioembolization ◽  
Advanced Stages ◽  
New Treatment ◽  
90Y Microspheres

Liver malignancies, either primary tumours (mainly hepatocellular carcinoma and cholangiocarcinoma) or secondary hepatic metastases, are a major cause of death, with an increasing incidence. Among them, hepatocellular carcinoma (HCC) presents with a dark prognosis because of underlying liver diseases and an often late diagnosis. A curative surgical treatment can therefore only be proposed in 20 to 30% of the patients. However, new treatment options for intermediate to advanced stages, such as internal radionuclide therapy, seem particularly attractive. Transarterial radioembolization (TARE), which consists in the use of intra-arterial injection of a radiolabelled embolising agent, has led to very promising results. TARE with 90Y-loaded microspheres is now becoming an established procedure to treat liver tumours, with two commercially available products (namely, SIR-Sphere® and TheraSphere®). However, this technology remains expensive and is thus not available everywhere. The aim of this review is to describe TARE alternative technologies currently developed and investigated in clinical trials, with special emphasis on HCC.

scholarly journals Yttrium-90 Microspheres for Intermediate- or Advanced-Stage Hepatocellular Carcinoma

2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Calvin Young ◽  
Anusree Subramonian ◽  
Charlene Argáez
Keyword(s):  
Hepatocellular Carcinoma ◽  
Adverse Events ◽  
Transarterial Chemoembolization ◽  
Systemic Treatment ◽  
Cost Effective ◽  
Economic Evaluations ◽  
Advanced Stage ◽  
Transarterial Radioembolization ◽  
90Y Microspheres ◽  
Yttrium 90

Transarterial radioembolization using yttrium-90 (90Y) microspheres is a therapeutic option for patients with intermediate- or advanced-stage hepatocellular carcinoma, including those with recurrent or inoperable hepatocellular carcinoma. Overall, the evidence suggests that patients treated with 90Y-based transarterial radioembolization may experience no difference in overall survival, progression-free survival, and tumour response when compared to patients who received transarterial chemoembolization therapies or systemic treatment with sorafenib or lenvatinib. Patients treated with transarterial radioembolization generally experienced similar rates of adverse events compared to those treated with transarterial chemoembolization, although there were some instances where treatment with transarterial radioembolization led to increased or decreased risks of specific adverse events. The comparative safety of transarterial radioembolization versus systemic treatment with sorafenib was unclear as the included studies did not statistically compare the risks of experiencing adverse events. Evidence regarding the cost-effectiveness of 90Y microspheres for treating hepatocellular carcinoma is conflicting. Three economic evaluations suggest treatment with transarterial radioembolization is likely to be cost-effective or dominant — less costly and more effective — compared to transarterial chemoembolization or systemic therapies, while a single economic study suggested treatment with sorafenib or lenvatinib is most likely to be cost-effective or dominant compared to transarterial radioembolization.

A Review of the Management of Hepatocellular Carcinoma: Standard Therapy and a Look to New Targets

2012 ◽  
pp. 275-280
Author(s):  
Andrew X. Zhu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Options ◽  
Mechanisms Of Action ◽  
Targeted Agents ◽  
Adjuvant Setting ◽  
Advanced Hcc ◽  
Molecularly Targeted Agents ◽  
Drug Eluting Beads ◽  
Drug Eluting ◽  
New Treatment

Overview: Management of hepatocellular carcinoma (HCC) continues to be challenging, but new treatment options are evolving. A multidisciplinary evaluation will help make the best treatment decisions for each patient. Although we continue to improve the outcomes of curative treatment with resection, liver transplant, and radiofrequency ablation (RFA), many new liver-directed regional therapies including drug-eluting beads, radioembolization, and radiation are emerging. Sorafenib remains the only approved agent for advanced HCC, and its role in the adjuvant setting following resection or RFA, with transarterial chemoembolization, or in combination with other targeted agents or chemotherapy in the advanced stage is under investigation. Many molecularly targeted agents with novel mechanisms of action are under active development.

scholarly journals Multidisciplinary treatment of advanced hepatocellular carcinoma with severe arterioportal shunt: a case report

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110248
Author(s):  
Yao-chang Luo ◽  
Hai-lin Lu ◽  
Wen-ling Song ◽  
Fei-fei Xuan
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multidisciplinary Approach ◽  
Treatment Options ◽  
Multidisciplinary Treatment ◽  
Advanced Hepatocellular Carcinoma ◽  
Term Survival ◽  
Arterioportal Shunt ◽  
Advanced Stages ◽  
Interventional Radiology Procedures

Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer mortality globally. In addition, most patients present in advanced stages with limited curative treatment options. Therefore, multidisciplinary treatment is often warranted. Here, we report a patient with HCC and severe arterioportal shunt (APS) who was treated with a multidisciplinary approach comprising interventional radiology procedures, apatinib and camrelizumab. After treatment, the intrahepatic mass was stable, and a notable decrease in the number and size of lung lesions was observed. The patient achieved a long-term survival of more than 2 years. These data suggest that multidisciplinary treatments may be effective in the treatment of advanced HCC with severe APS.

Neoplasms of the thymus

2016 ◽  
pp. 655-658
Author(s):  
Rebecca Bütof ◽  
Axel Denz ◽  
Gustavo Baretton ◽  
Jan Stöhlmacher-Williams ◽  
Michael Baumann
Keyword(s):  
Treatment Options ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Health Condition ◽  
Incomplete Resection ◽  
Complete Surgical Resection ◽  
General Health Condition ◽  
Advanced Stages ◽  
Low Incidence ◽  
New Treatment

Thymic tumours are among the malignant diseases with very low incidence. Therefore clinical research and development of new treatment options pose an ongoing challenge. For treatment of thymomas the following methods are used: surgery, radiotherapy, chemotherapy, and targeted drugs. The optimal type and sequence of therapy depends on tumour stage, histological subtype, and general health condition of the patient. A complete surgical resection is still the mainstay of therapy. For patients with incomplete resection or in locally advanced stages adjuvant radio/chemotherapy is recommended. Neoadjuvant treatment approaches and novel targeted therapies are under investigation. Lifelong follow-up has to be preferred because of possible late recurrences.

scholarly journals Targeted Toxins for the Treatment of Prostate Cancer

Biomedicines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 986
Author(s):  
Philipp Wolf
Keyword(s):  
Prostate Cancer ◽  
Treatment Options ◽  
Antigen Expression ◽  
Target Antigen ◽  
Clinical Use ◽  
Apoptosis Resistance ◽  
Advanced Stages ◽  
New Treatment ◽  
Therapeutic Alternatives ◽  
Targeted Toxins

Prostate cancer is the second most common cancer and the fifth leading cause of cancer deaths worldwide. Despite improvements in diagnosis and treatment, new treatment options are urgently needed for advanced stages of the disease. Targeted toxins are chemical conjugates or fully recombinant proteins consisting of a binding domain directed against a target antigen on the surface of cancer cells and a toxin domain, which is transported into the cell for the induction of apoptosis. In the last decades, targeted toxins against prostate cancer have been developed. Several challenges, however, became apparent that prevented their direct clinical use. They comprise immunogenicity, low target antigen binding, endosomal entrapment, and lysosomal/proteasomal degradation of the targeted toxins. Moreover, their efficacy is impaired by prostate tumors, which are marked by a dense microenvironment, low target antigen expression, and apoptosis resistance. In this review, current findings in the development of targeted toxins against prostate cancer in view of effective targeting, reduction of immunogenicity, improvement of intracellular trafficking, and overcoming apoptosis resistance are discussed. There are promising approaches that should lead to the clinical use of targeted toxins as therapeutic alternatives for advanced prostate cancer in the future.

scholarly journals Therapeutic Strategies in HCC: Radiation Modalities

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
R. Gallicchio ◽  
A. Nardelli ◽  
P. Mainenti ◽  
A. Nappi ◽  
D. Capacchione ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Options ◽  
Three Dimensional ◽  
Conformal Radiotherapy ◽  
Normal Liver ◽  
Great Promise ◽  
Radical Therapy ◽  
External Radiation Therapy ◽  
New Treatment ◽  
Three Dimensional Conformal Radiotherapy

Patients with hepatocellular carcinoma (HCC) comply with an advanced disease and are not eligible for radical therapy. In this distressed scenario new treatment options hold great promise; among them transarterial chemoembolization (TACE) and transarterial metabolic radiotherapy (TAMR) have shown efficacy in terms of both tumor shrinking and survival. External radiation therapy (RTx) by using novel three-dimensional conformal radiotherapy has also been used for HCC patients with encouraging results while its role had been limited in the past for the low tolerance of surrounding healthy liver. The rationale of TAMR derives from the idea of delivering exceptional radiation dose locally to the tumor, with cell killing intent, while preserving normal liver from undue exposition and minimizing systemic irradiation. Since the therapeutic efficacy of TACE is being continuously disputed, the TAMR with131I Lipiodol or90Y microspheres has gained consideration providing adequate therapeutic responses regardless of few toxicities. The implementation of novel radioisotopes and technological innovations in the field of RTx constitutes an intriguing field of research with important translational aspects. Moreover, the combination of different therapeutic approaches including chemotherapy offers captivating perspectives. We present the role of the radiation-based therapies in hepatocellular carcinoma patients who are not entitled for radical treatment.

scholarly journals Immunohistochemical staining reveals differential expression of ACSL3 and ACSL4 in hepatocellular carcinoma and hepatic gastrointestinal metastases

2020 ◽  
Vol 40 (4) ◽  
Author(s):  
Haarith Ndiaye ◽  
Jorlin Y. Liu ◽  
Andrew Hall ◽  
Shane Minogue ◽  
Marsha Y. Morgan ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Acyl Chain ◽  
Hepatic Metastases ◽  
Normal Liver ◽  
Subcellular Fractionation ◽  
Fatty Acyl ◽  
Liver Malignancies ◽  
Tissue Arrays ◽  
Chain Acyl ◽  
Long Chain

Abstract Long-chain fatty acyl CoA synthetases (ACSLs) activate fatty acids by CoA addition thus facilitating their intracellular metabolism. Dysregulated ACSL expression features in several cancers and can affect processes such as ferroptosis, fatty acid β-oxidation, prostaglandin biosynthesis, steroidogenesis and phospholipid acyl chain remodelling. Here we investigate long chain acyl-CoA synthetase 3 (ACSL3) and long chain acyl-CoA synthetase 4 (ACSL4) expression in liver malignancies. The expression and subcellular localisations of the ACSL3 and ACSL4 isoforms in hepatocellular carcinoma (HCC), cholangiocarcinoma (CCA) and hepatic metastases were assessed by immunohistochemical analyses of multiple tumour tissue arrays and by subcellular fractionation of cultured HepG2 cells. The expression of both enzymes was increased in HCC compared with normal liver. Expression of ACSL3 was similar in HCC and hepatic metastases but lower in healthy tissue. Increased ACSL3 expression distinguished HCC from CCA with a sensitivity of 87.2% and a specificity of 75%. ACSL4 expression was significantly greater in HCC than in all other tumours and distinguished HCC from normal liver tissue with a sensitivity of 93.8% and specificity of 93.6%. Combined ACSL3 and ACSL4 staining scores distinguished HCC from hepatic metastases with 80.1% sensitivity and 77.1% specificity. These enzymes had partially overlapping intracellular distributions, ACSL4 localised to the plasma membrane and both isoforms associated with lipid droplets and the endoplasmic reticulum (ER). In conclusion, analysis of ACSL3 and ACSL4 expression can distinguish different classes of hepatic tumours.

scholarly journals GASC1 promotes hepatocellular carcinoma progression by inhibiting the degradation of ROCK2

2021 ◽  
Vol 12 (3) ◽  
Author(s):  
Na Shao ◽  
Jiamin Cheng ◽  
Hong Huang ◽  
Xiaoshan Gong ◽  
Yongling Lu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transcriptional Repression ◽  
Rho Gtpase ◽  
Treatment Options ◽  
Standard Of Care ◽  
Malignant Cell ◽  
Tumor Stage ◽  
Downstream Target ◽  
Demethylase Activity ◽  
New Treatment

AbstractHepatocellular carcinoma (HCC) is a devastating malignancy without targeted therapeutic options. Our results indicated that the histone demethylase GASC1 signature is associated with later tumor stage and poorer survival in HCC patients. GASC1 depletion led to diminished HCC proliferation and tumor growth. A distinct heterogeneity in GASC1 levels was observed among HCC cell populations, predicting their inherent high or low tumor-initiating capacity. Mechanistically, GASC1 is involved in the regulation of several components of the Rho-GTPase signaling pathway including its downstream target ROCK2. GASC1 demethylase activity ensured the transcriptional repression of FBXO42, a ROCK2 protein-ubiquitin ligase, thereby inhibiting ROCK2 degradation via K63-linked poly-ubiquitination. Treatment with the GASC1 inhibitor SD70 impaired the growth of both HCC cell lines and xenografts in mice, sensitizing them to standard-of-care chemotherapy. This work identifies GASC1 as a malignant-cell-selective target in HCC, and GASC1-specific therapeutics represent promising candidates for new treatment options to control this malignancy.

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