COMBINATION OF TACE AND TKIs IN THE TREATMENT OF HEPATOCELLULAR CARCINOMA: FROM THEORY TO CLINICAL PRACTICE
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Tóm tắt
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Abstract
Background: Over recent decades, hepatocellular carcinoma (HCC) has remained one of the Major challenges in oncology, particularly in countries with a high prevalence of viral hepatitis, such as Vietnam. Intermediate-stage HCC according to the Barcelona Clinic Liver Cancer (BCLC-B) classification represents a heterogeneous population in terms of tumor burden and baseline liver function. Transarterial chemoembolization (TACE) is currently considered the standard treatment for this stage. However, not all patients are suitable candidates for TACE, and repeated TACE alone may lead to deterioration of liver function. The advent of tyrosine kinase inhibitors (TKIs) has ushered in a new era of systemic therapy for HCC, initially in advanced-stage disease, and subsequently explored in combination with TACE in earlier-stage settings to exploit the potential synergy between locoregional tumor control and inhibition of angiogenesis.
Objective: To review and analyze the available evidence regarding the efficacy and emerging trends of combining TACE with tyrosine kinase inhibitors in the treatment of HCC.
Methods: A narrative review of expert consensus statements, clinical studies, and treatment guidelines from the AASLD, EASL, and BCLC was conducted. Relevant literature was retrieved from PubMed, Google Scholar, ScienceDirect, and domestic Vietnamese medical journals.
Results: Recent evidence suggests that the combination of TACE and TKIs may improve tumor control and prolong progression-free survival in patients who are no longer suitable for TACE monotherapy, particularly when patient selection and treatment timing are optimized.
Conclusion: The combination of TACE and TKIs is increasingly regarded as a critical transitional strategy between locoregional and systemic therapies in the management of HCC. This approach highlights the need for further research to identify patients most likely to benefit, optimize treatment sequencing, and assess long-term efficacy and safety. In Vietnam, this combined modality is being progressively adopted in clinical practice.
Từ khóa
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Keywords
Hepatocellular carcinoma, transarterial chemoembolization (TACE), tyrosine kinase inhibitors (TKIs), combination therapy.
Tài liệu tham khảo (References)
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