The role of Interventional Radiology (IR/IO) in the management of primary liver tumors, hepatocellular carcinoma, and liver mets – a summary from GEST 2022.
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the third most common cause of cancer related death. Resection, ablative therapies, transarterial chemoembolization (TACE), radioembolization, systemic, and immune therapies are all treatment options available and selection is dependent on tumor burden, location, and comorbidities.
Immunotherapy is an increasingly popular approach to cancer treatment. Data shows that the objective response rate in a multitude of cancers is low (between 20-30%). Why is this, what can be done about it, and why should IR/IO care?
A review of many exciting and potential immunotherapies show that while there is promise in preclinical and phase I and II clinical trials, there is a high failure rate in phase III, indicating the importance of effective delivery. If the drug works perfectly but can’t get into the tumor, it’s still not going to do anything. There is where IR comes in!
IR is the key stakeholder in any intratumoral immunotherapy program. The job of IR/IO is to get the therapy where it needs to be. Of course, it’s not as simple as that. There are many physical barriers to delivery. But there are many tools in the toolkit and many tricks up the IR sleeve.
"The abscopal effect is real and image-guided cancer therapies may be the key to unlocking an immunotherapy’s potential. IR/IO plays a key role in how, what, and where these are delivered. But as with any intervention, technique matters! Getting it right can make a positive difference, getting it wrong can have a negative influence on the immuno environment.”
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