Expanding the Scope of Interventional Oncology: Locoregional Therapies in Extrahepatic Malignancies

TL;DR

This review explores how liver cancer treatments like embolization can also be used for other cancers outside the liver, showing promise in controlling tumors and improving survival.

Contribution

The paper reviews recent advancements in applying locoregional therapies to extrahepatic malignancies, highlighting their potential and challenges.

Findings

Locoregional therapies show promising tumor control and survival improvements in extrahepatic cancers.

These therapies offer minimal systemic toxicity and can be used palliatively for symptom management.

Standardization and combination approaches are needed to optimize their clinical use.

Abstract

Locoregional therapies, such as transarterial embolization, transarterial chemoembolization, and transarterial radioembolization, have traditionally been used to treat liver malignancies like hepatocellular carcinoma. However, more recently, their potential in treating extrahepatic cancers, such as glioblastoma, soft tissue sarcomas, prostate cancer, pancreatic cancer, and renal cell carcinoma, has gained increasing attention. This review explores the latest advancements in the utilization of these therapies for extrahepatic malignancies. Through a detailed examination of the literature to date, we highlight promising results in tumor control, progression-free survival, and symptom management, with each modality offering unique benefits. While these techniques show significant potential in expanding the treatment paradigm for certain cancers, challenges remain, including variability in protocols and long-term outcomes.

Background/Objectives: Locoregional therapies (LRTs), including transarterial embolization (TAE), transarterial chemoembolization (TACE), and transarterial radioembolization (TARE), have become integral in the management of hepatocellular carcinoma (HCC) in recent decades and continue to shape evolving treatment strategies. While their role in liver tumor management is well established, their potential for treating extrahepatic malignancies is gaining increasing attention. Notably, growing research has highlighted the promising applications of TAE, TACE, and TARE in extrahepatic cancers such as glioblastoma (GBM), soft tissue sarcomas (STSs), prostate cancer (PCa), pancreatic cancer, and renal cell carcinoma (RCC). This review aims to explore these novel applications, providing a comprehensive summary of the current literature, examining clinical outcomes, and discussing future directions for integrating these techniques into broader oncologic treatment strategies. Methods: A systematic literature review was conducted focusing on LRTs such as TAE, TACE, and TARE in extrahepatic malignancies. Studies published between May 1998 and December 2024 were included, emphasizing outcomes in GBM, STS, PCa, pancreatic cancer, and RCC. Data extraction prioritized clinical outcomes, safety profiles, and procedural efficacy. Results: LRTs demonstrated significant potential in managing extrahepatic malignancies, with TAE, TACE, and TARE showing promising results in palliative management and tumor control. Across studies, these therapies exhibited varying degrees of success in improving progression-free survival and overall survival, with minimal systemic toxicity. Conclusions: The expanding application of LRTs in extrahepatic malignancies highlights their transformative potential in interventional oncology. By offering targeted, minimally invasive treatment options, these modalities bridge critical gaps in managing tumors refractory to conventional therapies. Future research should focus on standardizing protocols, optimizing patient selection, and exploring combination therapies to maximize their clinical efficacy.